First Medicare Demonstration of Concurrent Provision of Curative and Hospice Services for End-of-Life Care
First Medicare Demonstration of Concurrent Provision of Curative and Hospice Services for End-of-Life Care
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DOI：
10.2105/ajph.2016.303238
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发表时间：
2016-08-01
影响因子：
12.7
通讯作者：
Connor, Stephen R.
中科院分区：
文献类型：
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作者：
Harrison, Krista L.;Connor, Stephen R.
临终关怀于20世纪70年代在美国发展，作为解决未满足的临终关怀需求的一种方式：以患者和家人喜欢的地点和方式提供疼痛和症状管理支持。在欧洲和澳大利亚，临终关怀是从一个先进的生命限制疾病的诊断时间向前，但在美国，医疗保险临终关怀福利限制了不再接受治疗的患者获得这些服务的资格。我们提供了35年来第一次医疗保险临终关怀示范的背景和分析，该示范将测试对绝症患者同时提供治疗和临终关怀服务的情况这一示范预示着美国临终关怀和姑息治疗的潜在政策变化，随着人口老龄化，对护理的需求增加，这可能会减少与患者和家庭偏好一致的临终护理的障碍。
Hospice developed in the United States in the 1970s as a way to address unmet needs for end-of-life care: support for pain and symptom management provided in the location and manner that the patient and family prefer. In Europe and Australia, hospice is available from the time of diagnosis of an advanced life-limiting illness onward, but in the United States, the Medicare hospice benefit restricts eligibility for these services to patients who no longer receive curative treatment.We provide background and analysis of the first Medicare hospice demonstration in 35 years that will test the concurrent provision of curative and hospice services for terminally ill individuals with a life expectancy of six months or less.This demonstration is a harbinger of potential policy changes to hospice and palliative care in the United States that could reduce barriers to end-of-life care that aligns with patient and family preferences as the demand for care increases with an aging population.