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Rules Change Could Increase Hospice Use
Date:12/22/2008

Those who currently want it must give up aggressive treatments, researchers say

MONDAY, Dec. 22 (HealthDay News) -- More people with life-threatening illnesses would seek hospice care if Medicare and other health insurers dropped the requirement that they give up aggressive treatment of their ailments, a new study finds.

That was especially true of blacks, but the issue was one of money, not race, said Dr. David Casarett, an associate professor of medicine at the University of Pennsylvania and leader of a group reporting the finding in the Dec. 22 online issue of Cancer.

"We looked at household finances, how much money was left at the end of the month," Casarett said. "African-Americans generally had less money at the end of the month. Money affects people's perceived need for hospice services. People with greater financial resources have other ways of getting the services that hospices provide. They could get home health care by paying a friend or neighbor to provide the service."

Under current Medicare rules, someone must have a prognosis of six months or less of life to get hospice services covered. They cannot get hospice services, which include a visiting nurse, a home health aide and a counselor, if they insist on continuing treatment. Hospice care focuses on quality-of-life issues such as pain reduction rather than curing the disease.

Casarett and his colleagues interviewed 283 people receiving cancer treatment at six oncology centers in the University of Pennsylvania Cancer Network, asking them about their perceived need for five hospice services and their preferences for continued cancer treatment. They concentrated on blacks, since statistics show they are less likely to seek hospice care.

"We found people who believed they could benefit from all of the services that hospices provide, yet some of them wanted treatment, which would keep them out of hospice care," Casarett said.'/>"/>

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