Loading...
Two recent review articles highlight limitations in the current U.S. hospice system.
Gazelle describes several factors that lead to underuse of hospice services. One is the mistaken belief that hospice services are limited to patients with cancer. Another is the erroneous notion that patients must have a do-not-resuscitate order. Also, referrals are often delayed because physicians overestimate life expectancy in patients with terminal cancers. Finally, the Medicare reimbursement structure, which provides a fixed per-diem fee to hospice programs, usually is inadequate for more expensive therapies and thus provides a disincentive to hospice enrollment for patients who want to continue such therapies as chemotherapy, radiation, dialysis, blood…