There was substantial variation in hospice provider disenrollment due to extended prognosis (10th–90th percentile 4.5%–14.6%, adjusted median odds ratio (MOR) 1.86, 95% confidence interval (CI) 1.82, 1.91) and revocation (10th–90th percentile 2.5%–10.1%, MOR 2.09, 95% CI 2.03, 2.14). ResultsĪmong 867,695 hospice enrollees with dementia, 70,945 (8.2%) were disenrolled due to extended prognosis and 43,133 (5.0%) revoked within 1-year of their index admission. Hospice, regional, and patient risk factors and variation were assessed with multilevel mixed-effects logistic regression models.
Outcome measures included hospice-initiated disenrollment for patients whose rate of decline ceased to meet the Medicare hospice eligibility guideline of “expected death within 6 months” (extended prognosis) and patient-initiated disenrollment (revocation).
Retrospective, observational cohort study of 100% Medicare beneficiaries with dementia aged 65 and older enrolled in the Medicare Hospice Benefit between July 2012 and December 2017. People with dementia (PWD) are at high risk for hospice disenrollment, yet little is known about patterns of disenrollment among the growing number of hospice enrollees with dementia.
0 kommentar(er)
