Characteristics of hospice care discharges and their length of service: United States, 2000.

OBJECTIVE To obtain the maximum benefit from hospice, a person should receive hospice services for at least 30 days. For many Americans, this goal is not being met. This report presents data on hospice care discharges for 2000. Selected trend data are also presented. METHODS Data are from the National Home and Hospice Care Survey. The data presented are numbers and percents by selected discharge characteristics. Length of service measures include average and median length of service and length of service intervals. RESULTS AND CONCLUSIONS There were 621,100 discharges from hospice care in 2000. The typical discharge was elderly, white, lived in a private or semiprivate residence with a caregiver to whom they were related, and died while in hospice care. The primary source of payment was Medicare. Most received three or more services, were seen by three or more service providers, received help from the hospice with at least one activity of daily living (ADL), were incontinent, and had mobility limitation. Cancer is the most common primary admission diagnosis, but the proportion decreased from 75 percent in 1992 to 58 percent in 2000. Most of the discharges did not receive timely care. Sixty-three percent of discharges received hospice care for less than 30 days. The average length of service was 46.9 days, and the median length of service was 15.6 days. Shorter lengths of service occurred for those who were living in institutions, did not receive help from the agency with ADLs, had a lower level of mobility limitation, and had a primary admission diagnosis of cerebrovascular disease. Of the noninstitutionalized discharges, those whose primary caregiver was a spouse had shorter lengths of service than those who were cared for by a child.