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Cited by 60Palliative Care and End-of-Life IssuesHospital Admissions and OutcomesGeriatric Care and Nursing Homes

Transitions Between Healthcare Settings of Hospice Enrollees at the End of Life

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Wang, Shi‐Yi, Aldridge, Melissa D., Gross, Cary P., Canavan, Maureen, Cherlin, Emily, Johnson‐Hurzeler, Rosemary, Bradley, Elizabeth·2016·Journal of the American Geriatrics Society
DOI 10.1111/jgs.13939PMC PMC4762182
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Abstract

Objectives: To characterize the number and types of care transitions in the last 6 months of life of individuals who used hospice and to examine factors associated with having multiple transitions in care. Design: Retrospective cohort study. Setting: One hundred percent fee‐for‐service Medicare decedent claims data. Participants: Medicare beneficiaries aged 66 and older who died between July 1, 2011, and December 31, 2011, and were enrolled in hospice at some time during the last 6 months of life. Measurements: Hierarchical generalized linear modeling was used to identify individual, hospice, and regional factors associated with transitions. The sequence of transitions across healthcare settings was described. Healthcare transitions after hospice enrollment included from and to the hospital, skilled nursing facility, home health agency program, hospice, or home without receiving any service in these four healthcare settings. Results: Of 311,090 hospice decedents, 31,675 (10.2%) had at least one transition after hospice enrollment, and this varied substantially across the United States; 6.6% of all decedents had more than one transition in care after hospice enrollment (range 2–19 transitions). Of hospice users with transitions, 53.4% were admitted to hospitals, 17.7% were admitted to skilled nursing facilities, 9.6% used home health agencies, and 25.8% had transitions to home without receiving the services from the healthcare settings examined. In adjusted analyses, decedents who were younger, nonwhite, enrolled in a for‐profit or small hospice program, or had less access to hospital‐based palliative care had significantly higher odds of having at least one transition. Conclusion: A notable proportion of hospice users experience at least one transition in care in the last 6 months of life, suggesting that further research on the effect of transitions on users and families is warranted.

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  • On average, patients transition between care environments 2.9 times in the last six months of life.

    “Wang et al. reported that, on average, patients transition between care environments 2.9 times in the last six months of life [17].”

    From Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study (2024) · cites this paper as [17]

    The Results section (page unavailable) reports a mean of 2.3 transitions, not 2.9, among hospice decedents who had at least one transition after enrollment. Only 10.2% of the study sample had such a transition, so that mean does not describe patients overall. (LLM, conf=0.90)

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Research works printed but not linked: 34

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Authors
Wang, S., Aldridge, M. D., Gross, C. P., Canavan, M., Cherlin, E., Johnson‐Hurzeler, R., & Bradley, E.
Affiliations
  • Yale Cancer Center (US)
  • James J. Peters VA Medical Center (US)
  • Yale University (US)
  • John D. Thompson Hospice Institute for Education, Training, and Research, Inc. Branford Connecticut
Corresponding author
Wang, Shi‐Yi
ORCID
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2016-02
Volume
64
Issue
2
Pages
314-322
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
DOI
10.1111/jgs.13939
PMC
PMC4762182
OpenAlex
W2279141215
Cited by
60
References
0
Citations by year
2026: 4 · 2025: 3 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 2 · 2017: 18 · 2016: 5
FWCI
10.25
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 17 d)
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Cancer Institute (1R01CA116398–01A2)
  • National Institute of Nursing Research (1R01NR013499–01A1)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
Keywords
care transitions, hospice care, end-of-life care, Medicare beneficiaries, hospitalization, skilled nursing facilities, home health care, access to palliative care, racial disparities, hospice enrollment
MeSH terms
Aged, Aged, 80 and over, Continuity of Patient Care, Female, Medicare, Hospitalization, Humans, Male, Patient Transfer, Retrospective Studies, Terminal Care, United States, Hospice Care

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