Patients with advanced heart failure enrolled in hospice have fewer emergency department visits, hospital days, and intensive care unit (ICU) stays. The study was published in the JACC: Heart Failure.

Researchers used a propensity-score matched sample of Medicare decedents with two or more heart failure discharges within six months to identify predictors of hospice hospitalizations, hospital stays, and emergency department visits for those enrolled and not enrolled in hospice.

This study sought to:

  1. Identify the predictors of hospice enrollment for patients with heart failure (HF)
  2.  Determine the impact of hospice enrollment on health care use.

Enrollment In Hospice

A total of 3,067 beneficiaries were in each group, with a mean age of 82 years. The researchers observed no differences in the characteristics, symptom burden, or functional status between the groups that were associated with enrollment in hospice.

The hospice group had significantly fewer emergency departments visits (2.64 versus 2.82), hospital days (3.9 versus 4.67), and ICU stays (1.25 versus 1.51) in the six months after the second heart failure discharge; they were also significantly less likely to die in the hospital (3 versus 56%) and had longer median survival (80 versus 71 days).

A tailored hospice model may be needed to increase enrollment and offer benefits to a heart failure population. Beneficiaries’ characteristics, including symptom burden and functional status, do not predict hospice enrollment. 

Patients With Heart Failure

Those patients who enrolled in hospice used less health care, survived longer, and were less likely to die in the hospital. A tailored hospice model may be needed to increase enrollment and offer benefits to patients with HF.