TY - JOUR
T1 - Palliative Radiotherapy in Medicare-Certified Freestanding Hospices
AU - Jarosek, Stephanie L.
AU - Virnig, Beth A.
AU - Feldman, Roger
N1 - Funding Information:
This work was supported by a grant from the American Cancer Society.
PY - 2009/5
Y1 - 2009/5
N2 - Hospice care is designed to provide a variety of services, including pain and symptom management, to terminally ill patients. Although palliative radiotherapy (PRT) has been shown to be effective in reducing pain and other symptoms related to tumor growth, only a few hospice patients receive this therapy. This analysis identifies Medicare-certified freestanding hospices that report use of radiotherapy using Medicare's Healthcare Cost Report Information System (HCRIS) dataset. Any reported cost for radiotherapy services was used to indicate provision of PRT because of the population served. The relationship of provider characteristics (ownership, profit status, percent of patients with a cancer diagnosis, geographic location, and size) with provision of PRT was analyzed. Overall, 23.8% of Medicare-certified freestanding hospices in the study population provided radiotherapy services in fiscal year 2002. Provision of radiotherapy services was associated with larger size (measured by total number of hospice days reported in the HCRIS), longer length of Medicare certification, not-for-profit status, and a higher proportion of patients surviving more than seven days after admission. The finding that size, length of Medicare certification, and profit status are associated with provision of radiotherapy services lends credence to suggestions that current reimbursement practices discourage the use of PRT in hospice care, particularly for low-volume hospices.
AB - Hospice care is designed to provide a variety of services, including pain and symptom management, to terminally ill patients. Although palliative radiotherapy (PRT) has been shown to be effective in reducing pain and other symptoms related to tumor growth, only a few hospice patients receive this therapy. This analysis identifies Medicare-certified freestanding hospices that report use of radiotherapy using Medicare's Healthcare Cost Report Information System (HCRIS) dataset. Any reported cost for radiotherapy services was used to indicate provision of PRT because of the population served. The relationship of provider characteristics (ownership, profit status, percent of patients with a cancer diagnosis, geographic location, and size) with provision of PRT was analyzed. Overall, 23.8% of Medicare-certified freestanding hospices in the study population provided radiotherapy services in fiscal year 2002. Provision of radiotherapy services was associated with larger size (measured by total number of hospice days reported in the HCRIS), longer length of Medicare certification, not-for-profit status, and a higher proportion of patients surviving more than seven days after admission. The finding that size, length of Medicare certification, and profit status are associated with provision of radiotherapy services lends credence to suggestions that current reimbursement practices discourage the use of PRT in hospice care, particularly for low-volume hospices.
KW - Medicare
KW - hospice
KW - palliative radiation
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U2 - 10.1016/j.jpainsymman.2008.05.003
DO - 10.1016/j.jpainsymman.2008.05.003
M3 - Article
C2 - 18789642
AN - SCOPUS:67349216360
SN - 0885-3924
VL - 37
SP - 780
EP - 787
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 5
ER -