Readmission among patients with cancer who were discharged with hospice care.

Authors

null

Joanna-Grace Mayo Manzano

The University of Texas MD Anderson Cancer Center, Houston, TX

Joanna-Grace Mayo Manzano, Andrea G. Barbo, Heather Y. Lin, Hui Zhao, Josiah Halm, Maria E. Suarez-Almazor

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

Other

Background: Palliative and hospice care are appropriate recommendations for patients with high symptom burden and who are at end of life. Patients with cancer who are discharged to hospice care are less likely to be readmitted and this is expected. There remains a proportion of patients however, who rescind hospice after enrolling. We sought to describe this subgroup of patients and determine their readmission rate. Methods: This is a retrospective cohort study using administrative data of adult patients discharged from a non-surgical solid tumor service at The MD Anderson Cancer Center who were discharged to hospice care. Readmission was defined as any rehospitalization after discharge regardless of timing. Descriptive statistics are presented. Results: There were 1,452 discharge encounters with a disposition of hospice in our cohort with 50 resulting in readmission (readmission rate=3.4%). The mean age of patients who were readmitted was 59 years. Majority of the readmitted patients were female (60%), had a religious affiliation (83%), were English-speaking (85%), and were from Texas (94%). 54% of the patients who were readmitted were married versus 42% who were either single, divorced, widowed or separated. 42% had Medicare insurance, 44% had private insurance, 4% were indigent, and 10% were self-pay. 75% of the patients had metastatic disease at time of first presentation at MD Anderson. Conclusions: Transitioning to hospice care is a difficult decision for most patients and caregivers. Rescinding hospice after discharge to seek acute care in the hospital potentially reflects the difficult and daunting nature of this transition. Our study provides an insight into the characteristics of patients who are readmitted after hospice care has been initiated. More analysis is needed to determine if the characteristics described are associated with readmission in this population. Other factors such as those that are related to the caregiver, the patient’s symptom burden, or the care setting, may need to be investigated as well to have a better understanding of why patients decide to rescind hospice.

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Abstract Details

Meeting

2017 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B: Patient Safety and Science of Quality

Track

Patient Safety,Science of Quality

Sub Track

Other

Citation

J Clin Oncol 35, 2017 (suppl 8S; abstract 46)

DOI

10.1200/JCO.2017.35.8_suppl.46

Abstract #

46

Poster Bd #

A14

Abstract Disclosures

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