Hospice Improves Care Quality For Older Adults With Dementia In Their Last Month Of Life.
Hospice Improves Care Quality For Older Adults With Dementia In Their Last Month Of Life.
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DOI：
10.1377/hlthaff.2021.01985
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发表时间：
2022-06
期刊：
影响因子：
9.7
通讯作者：
Aldridge, Melissa D.
中科院分区：
文献类型：
--
作者：
Harrison, Krista L.;Cenzer, Irena;Ankuda, Claire K.;Hunt, Lauren J.;Aldridge, Melissa D.
The Medicare hospice benefit was originally designed around a cancer disease paradigm but increasingly serves people living with dementia. At this time, almost half of all older adults receiving hospice care have dementia. Yet there is minimal evidence as to whether hospice benefits people living with dementia outside of nursing facilities. We asked whether and how perceived quality of last-month-of-life care differed between people living with dementia and persons without dementia and whether hospice use among people living with dementia was associated with higher perceived quality of care compared with the quality of care for people living with dementia who did not use hospice. We used nationally representative data from the National Health and Aging Trends Study and Medicare claims from 2011–17 to examine the impact of hospice enrollment on proxy perceptions of last-month-of-life care quality. Proxies of people living with dementia enrolled in hospice compared with proxies of those not enrolled more often reported care to be excellent (predicted probability: 52 percent versus 41 percent), more often reported having anxiety and sadness managed (67 percent versus 46 percent), and less often reported transitions in the last three days of life (10 percent versus 25 percent). There were no differences in the impact of hospice on proxy ratings of care for people living with dementia compared with ratings of care for people without dementia. Policy makers should consider these benefits when weighing changes to hospice policy and regulations that may affect people living with dementia.
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