Benchmarking Site of Death and Hospice Use
| Autor: | Jurgis Karuza, Suzanne M. Gillespie, Orna Intrator, Bruce Kinosian, Jiejin Li, Darlene Davis, Thomas Edes, Cari Levy |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Health Status Population Ethnic group Primary care 03 medical and health sciences Sex Factors 0302 clinical medicine Residence Characteristics Cause of Death Humans Medicine 030212 general & internal medicine education Veterans Affairs health care economics and organizations Aged Veterans Multinomial logistic regression Cause of death Aged 80 and over education.field_of_study Primary Health Care business.industry 030503 health policy & services Racial Groups Age Factors Public Health Environmental and Occupational Health Benchmarking Middle Aged Home Care Services United States humanities Death United States Department of Veterans Affairs Hospice Care Socioeconomic Factors Family medicine Female Residence 0305 other medical science business |
| Zdroj: | Medical Care. 58:805-814 |
| ISSN: | 0025-7079 |
| DOI: | 10.1097/mlr.0000000000001361 |
| Popis: | Objective The objective of this study was to examine site of death and hospice use, identifying potential disparities among veterans dying in Department of Veterans Affairs (VA) Home Based Primary Care (VA-HBPC). Methods Administrative data (2008, 2012, and 2016) were compiled using the VA Residential-History-File which tracks health care service location, daily. Outcomes were site of death [home, nursing home (NH), hospital, inpatient hospice]; and hospice use on the day of death. We compared VA-HBPC rates to rates of 2 decedent benchmarks: VA patients and 5% Traditional Medicare non-veteran males. Potential age, race, urban/rural residence and living alone status disparities in rates among veterans dying in VA-HBPC in 2016 were examined by multinomial logistic regression. Results In 2016, 7796 veterans died in VA-HBPC of whom 62.1% died at home, 11.8% in NHs, 14.7% in hospitals and 11.4% in inpatient hospice. Hospice was provided to 60.9% of veterans dying at home and 63.9% of veterans dying in NH. Over the 2008-2012-2016 period, rates of VA-HBPC veterans who died at home and rates of home death with hospice increased and were higher than both benchmarks. Among VA-HBPC decedents, younger/older veterans were more/less likely to die at home and less/more likely to die with hospice. Race/ethnicity and urban/rural residence were unrelated to death at home but veterans living alone were less likely to die at home. Conclusions Results reflect VA-HBPC's primary goal of supporting its veterans at home, including at the end-of-life, surpassing other population benchmarks with some potential disparities remaining. |
| Databáze: | OpenAIRE |
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