Benchmarking Site of Death and Hospice Use

A Case Study of Veterans Cared by Department of Veterans Affairs Home-based Primary Care

Bibliographic Data

ID9102469
AuthorsOrna Intrator (0000-0002-4173-0662, Geriatrics and Extended Care Data Analysis Center, Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Washington, DC, corresponding author), Jiejin Li (0000-0003-1525-7768, Geriatrics and Extended Care Data Analysis Center, Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Washington, DC, corresponding author), Suzanne M Gillespie (0000-0001-7135-0428, Canandaigua Veterans Affairs Medical Center, Canandaigua), Cari Levy (0000-0002-7485-280X, Eastern Colorado Health Care System, Aurora Colorado), Darlene Davis (0000-0002-5948-1844, Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Washington, DC), Thomas Edes (Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Washington, DC), Thomas E Edes (United States Department of Veterans Affairs), Bruce Kinosian (0000-0003-2098-6340, Geriatrics and Extended Care Data Analysis Center, Office of Geriatrics and Extended Care, US Department of Veterans Affairs, Washington, DC, corresponding author), Jurgis Karuza (Department of Psychology, SUNY at Buffalo State, Buffalo, NY)
Year2020
Volume58
Issue9
Pages805-814
Publication date2020-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001361
PMID32826746
OpenAlexW3080688015
LanguageEN
Citations received2
References cited23

OBJECTIVE: The objective of this study was to examine site of death and hospice use, identifying potential disparities among veterans dying in Department of Veterans Affairs (VA) Home Based Primary Care (VA-HBPC). METHODS: Administrative data (2008, 2012, and 2016) were compiled using the VA Residential-History-File which tracks health care service location, daily. Outcomes were site of death [home, nursing home (NH), hospital, inpatient hospice]; and hospice use on the day of death. We compared VA-HBPC rates to rates of 2 decedent benchmarks: VA patients and 5% Traditional Medicare non-veteran males. Potential age, race, urban/rural residence and living alone status disparities in rates among veterans dying in VA-HBPC in 2016 were examined by multinomial logistic regression. RESULTS: In 2016, 7796 veterans died in VA-HBPC of whom 62.1% died at home, 11.8% in NHs, 14.7% in hospitals and 11.4% in inpatient hospice. Hospice was provided to 60.9% of veterans dying at home and 63.9% of veterans dying in NH. Over the 2008-2012-2016 period, rates of VA-HBPC veterans who died at home and rates of home death with hospice increased and were higher than both benchmarks. Among VA-HBPC decedents, younger/older veterans were more/less likely to die at home and less/more likely to die with hospice. Race/ethnicity and urban/rural residence were unrelated to death at home but veterans living alone were less likely to die at home. CONCLUSIONS: Results reflect VA-HBPC's primary goal of supporting its veterans at home, including at the end-of-life, surpassing other population benchmarks with some potential disparities remaining

End-of-life care · Ethnic group · Family medicine · Hospice care · Nursing homes · Palliative care · Place of death · Residence · Veterans Affairs · Demography · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Palliative Care and End-of-Life Issues · Gerontology

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