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- Cancer (4)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 9 of 9 Research Studies DisplayedMakam AN, Tran T, Miller ME
The clinical course after long-term acute care hospital admission among older Medicare beneficiaries.
Investigators sought to examine the clinical course after long-term acute care (LTAC) admission. They found that hospitalized older adults transferred to LTAC hospitals had poor survival, spent most of their remaining life as an inpatient, and frequently underwent life-prolonging procedures. This prognostic understanding is essential to inform goals of care discussions and to prioritize healthcare needs for these adults. Given the exceedingly low rates of palliative care consultations, they recommend future research to examine unmet palliative care needs in this population.
AHRQ-funded; HS022418.
Citation: Makam AN, Tran T, Miller ME .
The clinical course after long-term acute care hospital admission among older Medicare beneficiaries.
J Am Geriatr Soc 2019 Nov;67(11):2282-88. doi: 10.1111/jgs.16106..
Keywords: Elderly, Medicare, Palliative Care, Patient-Centered Outcomes Research, Outcomes, Care Management, Healthcare Delivery
Wang SY, Aldridge MD, Gross CP
End-of-life care transition patterns of Medicare beneficiaries.
The researchers characterized the patterns of transitions in care and factors associated with multiple transitions in the last 6 months of life of U.S. decedents (N = 660,132). They found that 218,731 had four or more transitions within the last 6 months of life. Women, blacks, individuals younger than 85, and individuals without dementia were more likely to have four or more transitions.
AHRQ-funded; HS023900.
Citation: Wang SY, Aldridge MD, Gross CP .
End-of-life care transition patterns of Medicare beneficiaries.
J Am Geriatr Soc 2017 Jul;65(7):1406-13. doi: 10.1111/jgs.14891.
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Keywords: Elderly, Medicare, Palliative Care, Transitions of Care
Schuler MS, Joyce NR, Huskamp HA
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Using Medicare claims data for patients diagnosed with extensive-stage small-cell lung cancer, the authors used latent class analysis to identify classes of people with different care patterns. The findings showed substantial heterogeneity in patterns of care for patients with advanced cancer, which should be accounted for in efforts to improve end-of-life care.
AHRQ-funded; HS022998.
Citation: Schuler MS, Joyce NR, Huskamp HA .
Medicare beneficiaries with advanced lung cancer experience diverse patterns of care from diagnosis to death.
Health Aff 2017 Jul;36(7):1193-200. doi: 10.1377/hlthaff.2017.0448..
Keywords: Cancer, Cancer: Lung Cancer, Care Management, Elderly, Medicare, Palliative Care
Yim CK, Barron Y, Moore S
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Patients with advanced heart failure (HF) enroll in hospice at low rates, and data on their acute medical service utilization after hospice enrollment is limited. This descriptive analysis of Medicare fee-for-service beneficiaries found that home health care Medicare beneficiaries with advanced HF who enrolled in hospice had lower acute medical service utilization after their enrollment.
AHRQ-funded; HS020257.
Citation: Yim CK, Barron Y, Moore S .
Hospice enrollment in patients with advanced heart failure decreases acute medical service utilization.
Circ Heart Fail 2017 Mar;10(3). doi: 10.1161/circheartfailure.116.003335.
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Keywords: Cardiovascular Conditions, Heart Disease and Health, Healthcare Utilization, Medicare, Palliative Care
Jones CA, Acevedo J, Bull J
Top 10 tips for using advance care planning codes in palliative medicine and beyond.
This article highlights 10 tips to effectively using the new advance care planning codes reimbursable under Medicare and addresses the importance of documentation, proper billing, and nuances regarding coding.
AHRQ-funded; HS023681.
Citation: Jones CA, Acevedo J, Bull J .
Top 10 tips for using advance care planning codes in palliative medicine and beyond.
J Palliat Med 2016 Dec;19(12):1249-53. doi: 10.1089/jpm.2016.0202.
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Keywords: Medicare, Palliative Care
Wang SY, Hall J, Pollack CE
Associations between end-of-life cancer care patterns and Medicare expenditures.
The authors examined the extent to which patterns of intensive end-of-life care explain geographic variation in end-of-life care expenditures among cancer decedents. The mean expenditure per cancer decedent in the last month of life was $10,800, with considerable variation in the percentage of decedents receiving intensive end-of-life care intervention. Regional patterns of late chemotherapy or late hospice use explained only approximately 1% of the expenditure difference, while the proportion of decedents who had ICU admissions within 30 days of death was a major driver of variation, explaining 37.6% of the expenditure difference. They concluded that promoting appropriate end-of-life care has the potential to reduce geographic variation in end-of-life care expenditures.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Associations between end-of-life cancer care patterns and Medicare expenditures.
J Natl Compr Canc Netw 2016 Aug;14(8):1001-8.
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Keywords: Cancer, Elderly, Healthcare Costs, Medicare, Palliative Care
Wang SY, Hall J, Pollack CE
Trends in end-of-life cancer care in the Medicare program.
The researchers sought to examine contemporary trends in end-of-life cancer care and geographic variation of end-of-life care aggressiveness among Medicare beneficiaries. They found that the proportion of beneficiaries receiving at least one potentially aggressive end-of-life intervention increased in repeated hospitalization, repeated ED visits, ICU admissions, and late hospice enrollment but declined in in-hospital death. End-of-life chemotherapy use did not change significantly over time. They concluded that despite growing focus on providing appropriate end-of-life care, there has not been an improvement in aggressive end-of-life cancer care in the Medicare program.
AHRQ-funded; HS023900.
Citation: Wang SY, Hall J, Pollack CE .
Trends in end-of-life cancer care in the Medicare program.
J Geriatr Oncol 2016 Mar;7(2):116-25. doi: 10.1016/j.jgo.2015.11.007.
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Keywords: Cancer, Care Management, Elderly, Medicare, Palliative Care, Outcomes, Patient-Centered Outcomes Research, Practice Patterns
Holden TR, Smith MA, Bartels CM
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
The study objective was to examine the association between hospice enrollment, local hospice utilization patterns and 30-day rehospitalization in Medicare patients. It found that area-level hospice utilization is inversely proportional to rehospitalization rates. This relationship is not fully explained by direct hospice enrollment, and may reflect a spillover effect of the benefits of hospice extending to nonenrollees.
AHRQ-funded; HS000083.
Citation: Holden TR, Smith MA, Bartels CM .
Hospice enrollment, local hospice utilization patterns, and rehospitalization in Medicare patients.
J Palliat Med 2015 Jul;18(7):601-12. doi: 10.1089/jpm.2014.0395..
Keywords: Long-Term Care, Palliative Care, Hospital Readmissions, Medicare, Healthcare Utilization
Rocke DJ, Beumer HW, Taylor DH, Jr.
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
The investigators sought to determine how baseline attitudes toward quality vs quantity of life affect end-of-life resource allocation. They found that, compared with patients and caregivers, otolaryngology-head and neck surgery (OHNS) physician allocations differed significantly in all 15 benefit categories except home care. They concluded that understanding the effect of baseline attitudes is important for effective end-of-life discussions.
AHRQ-funded; HS018360.
Citation: Rocke DJ, Beumer HW, Taylor DH, Jr. .
Physician and patient and caregiver health attitudes and their effect on Medicare resource allocation for patients with advanced cancer.
JAMA Otolaryngol Head Neck Surg 2014 Jun;140(6):497-503. doi: 10.1001/jamaoto.2014.494.
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Keywords: Cancer, Caregiving, Medicare, Palliative Care, Provider: Physician, Quality of Life