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

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The researchers reported that "African-Americans had stronger preferences for aggressive cancer treatment compared with white patients. That is, they were willing to continue their treatment in spite of a smaller chance for six-month survival."

The researchers concluded that "the hospice eligibility criteria of Medicare and other insurers requiring patients to give up cancer treatment contribute to racial disparities in hospice use," and that "these criteria do not select those patients with the greatest needs for hospice services."

Those statements reflect Casarett's belief that "eligibility for hospice care should not depend on treatment. It should be determined by people's needs for hospice services."

The arrival of a new administration "is a great time for rethinking our health-care system," he said. "Medicare needs to rethink the way hospices are paid, so hospices will be able to provide more people the treatment they want or need."

The rules could be changed so that specific kinds of care could be provided -- for pain relief or management of other symptoms, as is now done in the Medicare Home Management Program, Casarett said.

More information

Learn about hospice through the U.S. National Library of Medicine.



SOURCES: David Casarett, M.D., associate professor, medicine, University of Pennsylvania, Philadelphia; Feb. 1, 2008, Cancer


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