Non-Cancer Diagnoses Continue to Outnumber Malignancies in Patients Served by Hospice
Continuing a trend from recent years, the percentage of hospice patients with a diagnosis other than cancer increased in 2007, according to a report issued in October 2008. As well, both the number of hospice agencies and the number of Americans with terminal illnesses who used hospice services rose significantly during that time period.
In its 2008 annual report, “NHPCO Facts and Figures: Hospice Care in America,” the National Hospice and Palliative Care Organization (NHPCO), provides comprehensive 2007 statistics for hospice care across the U.S.
Non-cancer diagnoses accounted for 58.7% of all hospice admissions during the year, up from 55.9% in 2006.
2007 Hospice Statistics: Non-Cancer Diagnoses
• Heart disease (11.8%)
• Debility unspecified (11.2%)
• Dementia, including Alzheimer’s disease (10.1%)
• Lung disease (7.9%)
• Stroke or coma (3.8%)
• Kidney disease, including end-stage renal failure (2.6%)
• Motor neuron diseases, including ALS (2.3%)
• Liver disease (2.0%)
• HIV/AIDS (0.6%)
• Other diagnoses (6.5%)Key findings include:
• Number of Hospices: In 2007, the number of hospice agencies in the U.S. was 4700, up from 4500 in 2006.
• Number of Patients: 1.4 million Americans received hospice services in 2007, up from 1.3 million in 2006.
• Time in Hospice: The amount of time that the average patient spent under hospice care increased from 59.8 days in 2006 to 67.4 days in 2007. However, almost 31% of patients died or were discharged in seven days or less.
• Hispanics: Use of hospice care by those who classified themselves as being of Hispanic or Latino origin increased slightly, from 4.9% of hospice patients in 2006 to 5.1% in 2007.
• Non-Caucasians: Use of hospice care by non-Caucasian Americans decreased slightly, from 19.1% of hospice patients in 2006 to 18.7% in 2007.
• Inpatient Facilities: 20% of hospice agencies operate an inpatient facility or unit. Approximately 450 of these units were in operation in 2007.
• Care at Home: Most patients received hospice care in the place they consider “home,” whether a private residence, nursing home, or residential facility. Hospice agencies classified 95.6% of their patient care days in 2007 as “routine home care.”
• Place of Death: During 2007, 70.3% of deaths among hospice patients occurred at home (patient’s place of residence), 19.2% occurred in a hospice inpatient facility, and 10.5% of patients died in an acute care hospital.
• Patient Age: In 2007, 82.6% of hospice patients were 65 or older (up from 81.7% in 2006). According to the NHPCO report, “As the U.S. population ages, the number of patients 65 and older is expected to grow.” At the other end of the age spectrum, less than 1% of all hospice patients were children or young adults.
• Patient Gender: As in prior years, more women than men used hospice services; however, this gap narrowed from 2006 (55.6% female) to 2007 (53.9% female).
• Hospice Size: Hospice agencies vary widely in size, serving anywhere from 50 or fewer patients per year to more than 1500 patients per year. In 2007, 79.4% of hospices admitted fewer than 500 patients per year.
• Hospice Structure: Hospices may be not-for-profit charitable organizations, for-profit organizations (either privately owned or publicly held), or government owned and run organizations. In 2007, 48.6% were not-for-profit, 47.1% were for-profit, and 4.3% were owned by federal, state, or local governments. The largest growth area in 2007 was for-profit hospice agencies.
• Payment: In 2007, Medicare paid for 83.6% of all hospice patients and 87% of all hospice patient care days. Private insurance paid for 8.5% of patients and 4.8% of patient care days, and Medicaid paid for 5% of patients and 4.5% of patient care days.
According to the NHPCO, “Financial concerns can be a major burden for many patients and families facing a terminal illness. Hospice care is covered under Medicare, Medicaid, and most private insurance plans, and patients receive hospice care regardless of ability to pay.”
The report also cites two studies. One found that hospice reduces medical costs; the other that hospice improves survival time.
The report is online at www.nhpco.org.
Reprinted with permission from Quality of Life Matters®, copyright 2009.
Published by Quality of Life Publishing Co., Naples, FL.
