Understanding Service Utilization & Quality of Life Post-Hospice Live Discharge

TL;DR

This study explores how patients and caregivers use services and experience quality of life after being discharged from hospice care.

Contribution

The study provides new insights into service utilization and quality of life following live hospice discharge.

Findings

Only 12.5% of patients visited urgent care, 8% had ER visits, and 8% were hospitalized within 3 months post-discharge.

Just 25% of patients reported a 'Good' quality of life after hospice discharge.

Only 33% used home health services and less than half used paid caregivers.

Abstract

Following a live discharge from hospice, patients and their caregivers often need to re-establish or transition to community resources as hospice services are no longer available. Although patients may no longer qualify for hospice, they often continue to experience complex medical and psychosocial needs. Therefore, coordinated service utilization following live discharge is critical to ensuring continuity of care, minimizing emergency room visits or caregiver burnout, and supporting quality of life (QOL) for both patients and caregivers. This study surveyed patient-caregiver dyads (n = 24) approximately 3 months following a live discharge due to extended prognosis, to better understand the services utilized and their QOL post-hospice care. Participants were an average age of 86 (SD 12.1), 83% female, and 79% White with 50% of participating living at home, while 42% were in long-term care. Within the first 3 months post discharge, 12.5% reported visiting an urgent care at least once, 8% reported at least one ER visit, and 8% reported at least one hospitalization. Further, 62% reported an established primary care provider while only 33% reported using home health, and less than half (46%) reported use of paid caregivers. Lastly, only 25% of patients reported “Good” QOL in the immediate post-discharge period. Results demonstrate that in the initial post-discharge period, medical service utilization is relatively low as is reported QOL. Research, clinical, and policy implications will be discussed.