Study Finds Medicare Dialysis Patients Die within 4 Days of Entering Hospice

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A research team at Brigham and Women’s Hospital conducted a study to gauge the frequency of concurrent hospice and dialysis care among veterans with ESRD (end stage renal disease) and how that concurrent care varied depending on the hospice payer.  They compared Medicare, Veterans Administration in-patient hospice, and Veterans Administration-financed community hospice.  

Patient Choices

Patients who use Medicare Hospice Benefits with end stage renal disease (ESRD) are faced with choosing either enrollment in hospice or continuing their dialysis treatments.  The Veterans Health Administration (VA),  on the other hand has more relaxed criteria for entering hospice as compared to Medicare.  The VA does allow for patients in hospice care to also continue receiving dialysis treatments.  

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Study Results

The research team conducted a study of all 70,577 Veterans Administration enrollees in the US Renal Data System Registry.  The team then concluded that the patients who received VA-financed hospice services were more likely to receive ongoing dialysis at the same time, as compared to patients who had Medicare financed hospice care.   The team found that patients who stopped their dialysis treatments before they entered hospice care, died on an average of within four days of entering hospice.  Comparatively, patients who continued with dialysis while also in hospice care lived an average of about 43 days after entering hospice care.  

Lead author of the study, Melissa Wachterman MD, MPH said

“Because patients who are on dialysis for kidney failure die within days to weeks after stopping dialysis, they are particularly vulnerable to Medicare’s terrible choice if they want to receive hospice services, they can expect to live only a very short time after hospice enrollment. Our study will provide critical perspective as Medicare is currently considering whether it should change the Medicare Hospice Benefit to allow for concurrent care."

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Related Articles

‍What is Dialysis?

The Federal Government Improvement Plan for Dialysis Centers

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References

JAMA Network

News-Medical.net

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About the Author

Monica McCarthy has bachelors in Political Science and Criminal Justice from Central Washington University.  A majority of her career was spent as a political consultant.   She currently works at KidneyLuv as a staff writer.

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Patient Education Disclaimer

This material is for informational purposes only. It does not replace the advice or counsel of a doctor or health care professional. KidneyLuv makes every effort to provide information that is accurate and timely, but makes no guarantee in this regard. You should consult with, and rely only on the advice of, your physician or health care professional.

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