Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier
WebMD

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine
WebMD

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion
    WebMD

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community
    WebMD

    Community

    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Palliative Care Center

Font Size
A
A
A

Study: Shift to Hospice Care Often Comes Too Late

continued...

During that same period, the use of hospice care also increased significantly. In 2000, 21.6 percent of people received hospice care at the time of their death. That number was 32.3 percent in 2005 and 42.2 percent in 2009.

In 2009, however, 28.4 percent of hospice care was for three days or less, according to the study. And 40 percent of those short hospice stays came on the heels of an ICU stay.

"This was not what I expected to see," Teno said. "We've done a good job improving the numbers of people receiving hospice care, but the pattern of care we see in this study suggests that hospice has become an add-on treatment to aggressive care."

Teno said there is "a complex set of reasons" why this is occurring. One reason can be a sudden change in health status that doesn't leave people time to prepare. Another reason is that people are referred late to hospice care. Patients may not understand their prognosis, she said, and they may have never had a discussion with their doctor about what is important to them.

Another issue is the way services are reimbursed. There is no question that ICU care and ICU doctors are reimbursed for their services. But Medicare doesn't pay for primary-care doctors or specialists to sit down with their patients and have discussions about end-of-life care. Teno said this type of care was initially included in the Affordable Care Act, but was removed during political negotiations when the bill was making its way through Congress.

The study also found that people with some conditions, such as chronic obstructive pulmonary disease or emphysema, were less likely to get hospice care than someone who had cancer.

Both Teno and Tinetti said the findings show that you need to advocate for yourself or your loved ones. Ask the doctor what the prognosis is. If it's your parent or spouse, talk to them about what's truly important to them. Do they want every measure to be taken or do they want to just be as comfortable as possible at the end of their lives?

Today on WebMD

Nurse with patient
Article
Grieving father and daughter
Article
 
Computer search
Article
Nurse with patient
Article
 
Nurse with patient
Article
Doctor with patient
Article
 
Nurse talking to older man
Article
A caring hand
Article
 
In hospital with child
Article
Child with grandmother
Article
 
Man comfortable in nursing home
Article
Concerned doctor
Article