title: Health-Care Utilization After Hospice Enrollment in Patients With Heart Failure and Cancer.
abstract: This study aimed to examine the role of diagnosis in health-care utilization patterns after hospice enrollment. Using 2007 National Home and Hospice Care Survey data from hospice patients with heart failure (n = 311) and cancer (n = 946), we analyzed emergency service use and discharge to hospital via logistic regression pre- and postpropensity score matching. Prematching, patients with heart failure had twice the odds of emergency services use than patients with cancer ( P < .001) and twice the odds of discharge to hospital ( P = .02). Differences were reduced postmatching for emergency service use (odds ratio [OR]: 1.6, P = .05) and eliminated for discharge to hospital (OR: 1.32, P = .45). Health-care utilization correlates included diagnosis, place of care, and advance directives. Attention to the unique needs of patients with heart failure is needed, along with improved advanced care planning.
authors.affiliation: 1 Villanova University College of Nursing, Villanova, PA, USA.
authors.forename: Meredith A
authors.initials: MA
authors.lastname: MacKenzie
authors.affiliation: 2 University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
mesh_terms: D016223:Advance Directives / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D003072:Cognition Disorders / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology*; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: cancer; health-care utilization; heart failure; hospice care; outcomes; quality of care