Home health care linked to increased hospice use at end-of-life, study reveals

Home health care use in the last three years of a patient's life is associated with a higher likelihood of hospice care at the end of life, according to a Rutgers Health study.

Researchers, whose findings are published in the Journal of Palliative Medicine, examined the home health care and hospice care experiences of more than 2 million people.

"In addition to benefits for the patient, hospice care also provides resources and support to help family caregivers cope with the physical, emotional and practical challenges of caring for a loved one at the end of life," said Olga Jarrín, senior author of the study, the Hunterdon Professor of Nursing Research at the Rutgers School of Nursing and director of the Community Health and Aging Outcomes Laboratory within the Rutgers Institute for Health, Health Care Policy and Aging Research.

Using Medicare data, researchers found when individuals received home health care before the last year of their life, they had higher odds of using hospice care than those who had never received home health care. Researchers said this association underscores the potential benefits of receiving end-of-life care in the comfort of one's home.

"By providing personalized care, reducing hospitalizations, fostering family involvement and support, and improving symptom management, home-based care can enhance the quality of end-of-life experiences for patients with terminal illnesses and their families," said Hyosin (Dawn) Kim, research assistant professor at Oregon State University and first author of the study.

As the aged population increases, the findings also show the need for more resources in the health care sector and staff training in end-of-life care.

Home health care services including skilled nursing, therapy, social work and aide services are used to maintain functioning or slow decline in health. Hospice care provides similar services but is intended for those with life expectancies of six months or less and is focused on pain relief, minimizing hospital visits and providing comfort and support. Both services provide patients the opportunity to receive more personalized care in their home.

Researchers say home-based care also encourages greater involvement of family caregivers in the caregiving process.

Co-authors of the study include Paul Duberstein of the Rutgers School of Public Health, Haiqun Lin of the Rutgers School of Nursing, Bei Wu of New York University Rory Meyers College of Nursing and Anum Zafar of the Rutgers Institute for Health, Health Care Policy and Aging Research.