Doc Talk: who is hospice for and where do they get it?
On today’s Doc Talk, Midland Care Medical Director, Dr. David Wensel, speaks on the newest facts on hospice in America from the new NHCPO Facts and Figures report.
Happy Halloween! On today's Doc Talk, Midland Care Medical Director, Dr. David Wensel speaks on the newest facts on hospice in America.
Posted by Midland Care Connection, Inc. on Tuesday, October 31, 2017
Dr. David Wensel here today for Doc Talk. We missed last week because I was out of town and also happy Halloween today! It is Halloween here, so I just wish you guys happy Halloween.
I am going to continue the conversation about some of the facts and figures about hospice here in America. Last time we met, I talked about the fact that hospice care in America looks quite different now and the statistics I am giving you comes from the National Hospice and Palliative Care Organization (NHCPO) Facts and Figures information. If you remember, last time I told you that something like 30% of patients had less than 7 days of hospice care in America, which was really surprising to me. We also talked about the age group, those being greater than 84 making up almost 48% of the people that got hospice care. So the population is aging more but getting less days of actual hospice care.
The next thing that actually goes along with that is actually talking about which diagnosis received the most hospice care. It’s interesting that the patients with the principle diagnosis of cancer were the highest percentage. Almost 28% of people who received hospice care had a cancer diagnosis. But their length of stay was really short. They only had a median length of stay of 19 days, which is a higher percentage of population with that diagnosis but much lower amount of care. The diagnosis that got the most care was dementia. Seventeen percent of people in America who had hospice care, for the year 2015, 17% had the diagnosis of dementia, on average received the total of median length of 56 days of hospice care. Dementia has a smaller percentage of people with that diagnosis but receiving more days of care. That goes right along with how we know how difficult it is to prognosticate with patients who have dementia. It is really difficult to know when they have six months or less to live. In 2015, the median length of service, all diagnosis in hospice was 23 days. Twenty-nine percent of those patients had less than 7 days. Almost 14% of patients had between 15 and 30 days, that was the max.
So where is that care at? Interesting, to me, is looking at where the location of care was actually at. Fifty-six percent of hospice care in 2015 was in home. That means living out in the community. Forty-one percent was in nursing facilities and 1.3 percent was in hospice in-patient facilities, so most of that care is in the communities. Here at Midland Care, one of the things we talk about all the time is, close to 80% of the patients we take care of in our hospice here are out in the community, with only about 20% being in nursing facilities. It’s one of those questions I always encourage people to ask when they are looking at hospices or interviewing them: “what percentage of their care is out in the community, what percentage is in nursing facilities and do you have a hospice in-patient facility?” Which we do.
So, again, the majority of patients had less than 7 days care, the diagnosis that had the most days of care was dementia and the greatest location of care was home. Thanks again for your likes, shares and your questions. I am going to continue this discussion over the next couple of weeks to finish up the facts and figures about hospice care in America and I hope you have a Happy Halloween.