Shedding light on the impact of hospice care
James M. Berklan
While there seems to be some disagreement over Malcolm Gladwell's posit that doing something for 10,000 hours will make you a master at it, the idea that practice leads at least to improvement has received another shot in the arm. (That would be hospice providers you hear cheering in the background.)
While hospice enrollment has been shown to reduce the risk of hospitalization for nursing home residents who use it, less was known about other residents at involved facilities. Until now.
It turns out that hospice care, with regard to lowering hospital admissions, is good for both those enrolled in it and those who aren't at a given facility. Talk about your good timing. There are few issues hotter among providers, regulators and payers than lowering hospital readmission rates.
The core finding is worth repeating: “Every 10% increase in hospice penetration leads to a reduction in hospitalization risk of 5.1% for non-hospice residents and 4.8% for hospice-enrolled residents.”
It's likely a corollary on studies that have found the safest place to get open-heart surgery is a place where they do a lot of open-heart surgeries. (Sub in the names of other potential end-of-life surgeries or conditions at will.)
The research team that studied records for three-quarters of a million deceased Medicare beneficiaries in more than 14,000 facilities (a vast majority of U.S. nursing homes) has a winner here. It's looking like investigators Nan Tracy Zheng, PhD; Dana B. Mukamel, PhD; Bruce Friedman, PhD; Thomas V. Caprio, MD; and Helena Temkin-Greener, PhD, are going to be especially interesting conversationalists for a while. (Before you go hunting, I'll add that these researchers declared no conflicts of interest.)
They will, however, need to hone up on their self-promotion a bit.
“Higher facility-level hospice penetration reduces hospitalization risk for both non-hospice and hospice-enrolled residents,” they wrote. “The findings shed light on nursing home end-of-life care delivery, collaboration among providers, and cost benefit analysis of hospice care.”
Resident care and collaboration among providers are two laudable topics, but when you get to cost-benefit analysis, now you're really going to get some ears to perk up.
In fact, hospice providers' collective ears should be burning. What a strangely good sensation it should be.
But now that more light is being shed, can they get more people to see? That is the real question — and opportunity — presented.
James M. Berklan is McKnight's Editor.