Disrupting the Connection between Hospice Admission and the Cessation of Dialysis  Treatment

Ghulam Mustafa , Feras Almarshad

Authors

Ghulam Mustafa , Feras Almarshad Author

Abstract

Objective: To examine the latest trends and predictors utilization of hospice, ascertain the suitable hospice care duration, and investigate the discontinuation of dialysis without enrollment hospice among patients with end-stage renal disease.

Study Design A Prospective study

Place and Duration of Study: This study was conducted at the department of Medicine Nishtar hospital, Multan from January 2021 to December 2022.

Methods: A pre-designed questionnaire was utilized to gather comprehensive data on demographic characteristics, diagnoses, biochemical markers, clinical history, and claims patient’s information with end-stage renal disease (ESRD). The final dataset consisted of 300 unique records for ESRD patients who had passed away during the study duration.

Results: The mean duration of hospice of enrolled hospice patients was greater than not enrolled hospice patients as 17.74±4.94 days and 12.39±4.58 days, respectively, (p<0.001). Whereas, most of the not enrolled hospice patients had <15 days of hospice care 75.9%.

Conclusion: Median hospice duration before death: 5 days; Elderly, and non-kidney transplant recipients more likely to enroll; Hospice duration increasing; Need for better coordination in ESRD and hospice care; Patients discontinuing dialysis without hospice likely need different interventions; Medicare barrier to hospice enrollment should dissolve post-dialysis cessation.