This retrospective study examined 180 hospice patients referred from a comprehensive cancer center over 6 months in 2002 to (1) identify the variables associated with shorter length of survival (LOS) in hospice and (2) examine the LOS in hospice for those who previously participated in clinical trials and/or phase I studies. The median LOS in hospice for this cohort was 35 days. In multivariate analysis, low Palliative Performance Score (PPS) at hospice enrollment and male gender were associated with shorter LOS in hospice: males with low PPS had the shortest LOS while females with high PPS had the longest LOS. No correlation was found between the LOS in hospice and prior participation in clinical trials and/or phase I studies.
Earle CC, Park ER, Lai B., Weeks JC, Ayanian JZ, Block S.Identifying potential indicators of the quality of end-of-life cancer care from administrative data. J Clin Oncol. 2003 ;21:1133-1138.
2.
Yabroff KR, Mandelblatt JS, Ingham J.The quality of medical care at the end-of-life in the USA: existing barriers and examples of process and outcome measures. Palliat Med . 2004;18(3):202-216.
3.
National Hospice Organization Stats/Research/ Resources: Facts and Figures on Hospice Care in America. http://www.nhpco.org/files/public/2005-facts-and-figures.pdf . Accessed November 10, 2006.
4.
General Accounting Office.Medicare: More Beneficiaries Use Hospice but for Fewer Days of Care. Washington, DC: United States General Accounting office ; publication No.GAO/HEHS-00-182, 2000. http://www.gao.gov/archive/2000/he00182.pdf. Accessed November 10, 2006.
5.
Christakis NA , Iwashyna TJAttitude and self-reported practice regarding prognostication in a national sample of internists. Arch Intern Med. 1998;158:2389-2395.
6.
Social Security Act 1861 (dd)(3)(A). http://www.ssa.gov/OP_Home/ssact/title18/1861.htm#dd3A. Accessed November 10, 2006.
7.
Kapo J., Harrold J., Carroll JT, Rickerson E., Casarett D.Are we referring patients to hospice too late? Patients’ and families’ opinions. J Palliat Med. 2005;8(3):521-527.
8.
Rickerson E. , Harrold J., Kapo J., Carroll JT, Casarett D.Timing of hospice referral and families’ perceptions of services: are earlier hospice referrals better? J Am Geriatr Soc. 2005;53(5):819-823.
9.
Casarett DJ, Crowley R., Hirschman KBSurveys to assess satisfaction with end-of-life care: does timing matter? J Pain Symptom Manage. 2003;25(2):128-132.
10.
Stillman MJ , Syrjala KLDifferences in physician access patterns to hospice care. J Pain Symptom Manage. 1999;17:157-163.
11.
Rosenthal MA , Gebski VJ, Kefford RF, et al: Prediction of life expectancy in hospice patients: identification of novel prognostic factors. Palliat Med. 1993;7:199-204.
12.
Christakis NATiming of referral of terminally ill patients to an outpatient hospice. J Gen Intern Med. 1994;9:314-320.
13.
Christakis N. , Escarce J.Survival of Medicare patients after enrollment in Hospice programs. N Engl J Med. 1996;335:172-178.
14.
Christakis NAPredicting patient survival before and after hospice enrollment. Hospice J. 1998;13:71-87.
15.
Christakis NA , Iwashyna TJImpact of individual and market factors on the timing of initiation of hospice terminal care. Med Care . 2000;38:528-541.
16.
Casarett DJDifferences between patients referred to hospice from academic vs. non-academic settings. J Pain Symptom Manage. 2001;21:197-203.
17.
Virnig BA, Fisher ES, McBean AM, Kind S.Hospice use in Medicare managed care and fee-for-service systems. Am J Manag Care. 2001;7(8):777-786.
18.
Virnig BA, McBean M., Kind S., Kind S., Dholakia R.Hospice use before death: variability across cancer diagnoses. Med Care. 2002;40:73-78.
19.
Lamont EB, Christakis NAPhysician factor in the timing of cancer patient referral to hospice palliative care. Cancer. 2002;94:2733-2737.
20.
McCarthy EP , Burns RB, Ngo-Metzger Q., Phillips RSBarriers to hospice care among older patients dying with lung and colorectal cancer. J Clin Oncol. 2003;21: 728-735.
21.
McCarthy EP , Burns RB, Ngo-Metzger Q., Davis RB, Phillips RSHospice use among Medicare managed care and fee-for-service patients dying with cancer. JAMA. 2003;289(17):2238-2245.
22.
Younis T., Milch R., Abul-Khoudoud N., Lawrence D., Mirand A., Levine EGLength of survival of cancer patients in hospice: a retrospective analysis of patients treated at a major cancer center versus other practice settings . J Palliat Med. 2007;10(2):381-389.
23.
Anderson F. , Downing GM, Hill J., Casorso L., Lerch N.Palliative performance scale (PPS): a new tool. J Palliat Care. 1996;12:5-11.
24.
Virik K., Glare P.Validation of the palliative performance scale for inpatients admitted to a palliative care unit in Sydney, Australia. J Pain Symptom Manage. 2002;23: 455-457.
25.
Harrold J., Rickerson E., Carroll JT, et al. Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population? J Palliat Med. 2005;8:503-509.
26.
Head B., Ritchie CS, Smoot TMPrognostication in hospice care: can the palliative performance scale help ? J Palliat Med. 2005;8:492-502.
27.
Lau F., Downing GM, Lesperance M., Shaw J., Kuziemsky C.Use of Palliative Performance Scale in end-of-life prognostication. J Palliat Med. 2006;9(5):1066-1075.
28.
Agrawal M., Grady C., Fairclough DL, Meropol NJ, Maynard K., Emanuel EJPatients’ decision-making process regarding participation in phase I oncology research. J Clin Oncol. 2006;24(27):4479-4484.
29.
Byock I., Miles SHHospice benefits and phase I cancer trials. Ann Intern Med . 2003;138:335-337 [comments and authors reply in Ann Intern Med. 2004;140(1):70-71].
30.
Casarett DJ , Karlawish JH, Henry MI, Hirschman KBMust patients with advanced cancer choose between a phase I trial and hospice? Cancer. 2002;95(7):1601-1604.
31.
Vigano A., Dorgan M., Bruera E., Suarez-Almazor METhe relative accuracy of the clinical estimation of the duration of life for patients with end of life cancer. Cancer. 1999;86:170-176.
32.
Christakis NA, Lamont EBExtent and determinants of error in doctors’ prognoses in terminally ill patients: Prospective cohort study. BMJ. 2000;320:469-473.
33.
Chow E., Harth T., Hruby G., Finkelstein J., Wu J., Danjoux C.How accurate are physicians’ clinical predictions of survival and the available prognostic tools in estimating survival times in terminally ill cancer patients? A systematic review. Clin Oncol. 2001;15:203-218.
