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. 2020 Jun;39(6):1060-1064.
doi: 10.1377/hlthaff.2019.01549.

Trends In Residential Setting And Hospice Use At The End Of Life For Medicare Decedents

Melissa D Aldridge  1 , Katherine A Ornstein  2 , Karen McKendrick  3 , Jaison Moreno  4 , Jennifer M Reckrey  5 , Lihua Li  6
Affiliations

Trends In Residential Setting And Hospice Use At The End Of Life For Medicare Decedents

Melissa D Aldridge et al. Health Aff (Millwood). 2020 Jun.

Abstract

As more people live and die in the community despite complex health needs and functional impairment, the need for hospice increases. We found high and increasing penetration of hospice in community-based residential settings, compared with hospice use in private residences and nursing homes.

Keywords: Activities of daily living; Dementia; End of life care; Hospice; Housing; Long term services and supports; Medicare savings programs; Nursing homes; Older adults; Populations; health policy.

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Figures

Exhibit 1
Exhibit 1. Proportion of Medicare decedents who used hospice, by residential setting, 2002–17
SOURCE Authors’ analysis of data for Medicare beneficiaries who died during 2002–17 (excluding data for 2014) from the Medicare Current Beneficiary Survey. NOTES N = 8,394. Community-based residential settings include assisted living facilities, continuing care communities, retirement communities, and senior citizen housing. The error bars indicate 95% confidence intervals.
Exhibit 2
Exhibit 2. Demographic and socioeconomic characteristics of Medicare decedents, by residential setting, 2002–17
SOURCE Authors’ analysis of data for Medicare beneficiaries who died in 2002–17 (excluding data for 2014) from the Medicare Current Beneficiary Survey. NOTES The sample size is in the notes to exhibit 1. The error bars indicate 95% confidence intervals. Community-based residential settings are defined in the notes to exhibit 1. “Medicaid” means enrolled in Medicaid.
Exhibit 3
Exhibit 3. Clinical and functional characteristics of Medicare decedents, by residential setting, 2002–17
SOURCE Authors’ analysis of data for Medicare beneficiaries who died in 2002–17 (excluding data for 2014) from the Medicare Current Beneficiary Survey. NOTES The sample size is in the notes to exhibit 1. The error bars indicate 95% confidence intervals. Community-based residential settings are defined in the notes to exhibit 1. ADL is activity of daily living.
Exhibit 4
Exhibit 4. Trends in proportions of Medicare decedents, by residential setting and hospice use, 2001–17
SOURCE Authors’ analysis of data for Medicare beneficiaries who died in 2002–17 (excluding data for 2014) from the Medicare Current Beneficiary Survey. NOTES The sample size is in the notes to exhibit 1. Community-based residential settings are defined in the notes to exhibit 1. For the lines showing hospice use, p value of test for trend in hospice use over time for each of the three settings is less than 0.05.
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References

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