Trends in Hospice Discharge and Relative Outcomes Among Medicare Patients in the Get With The Guidelines-Heart Failure Registry

JAMA Cardiology
Haider J WarraichLarry A Allen

Abstract

While 1 in 10 older patients hospitalized with heart failure (HF) die within 30 days, end-of-life care for this population is not well described. To assess rates of discharge to hospice, readmission after hospice, and survival in hospice in patients following hospital discharge. In this observational cohort analysis of patients in the multicenter American Heart Association Get With The Guidelines (GWTG)-HF registry linked to Medicare fee-for-service claims data, we analyzed patients 65 years and older discharged alive from the hospital between 2005 and 2014. We compared 4588 patients discharged to hospice with 4357 patients with advanced HF (ejection fraction ≤25% and any of the following: inpatient inotrope use, serum sodium level ≤130 mEq/L, blood urea nitrogen level ≥45 mg/dL [to convert to micromoles per liter, multiply by 0.357], systolic blood pressure ≤90 mm Hg, or comfort measures during hospitalization) not discharged to hospice and with 113 045 other patients with HF in the GWTG-HF registry. Data were analyzed from October 2017 to June 2018. Discharge to hospice, rehospitalization, and mortality. Of the 4588 patients discharged to hospice, 2556 (55.7%) were female and 4047 (88.2%) were white, and they had a median (in...Continue Reading

Associated Clinical Trials

Oct 30, 2018·Scott Halpern

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Citations

Oct 13, 2018·Journal of Palliative Medicine·Haider Javed WarraichRobert J Mentz
Mar 30, 2019·The American Journal of Hospice & Palliative Care·Lee BurnsideStephanie G Cooper
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