Haupt Barbara J
Vital Health Stat 13. 2003 Aug(154):1-36.
To obtain the maximum benefit from hospice, a person should receive hospice services for at least 30 days. For many Americans, this goal is not being met. This report presents data on hospice care discharges for 2000. Selected trend data are also presented.
Data are from the National Home and Hospice Care Survey. The data presented are numbers and percents by selected discharge characteristics. Length of service measures include average and median length of service and length of service intervals.
There were 621,100 discharges from hospice care in 2000. The typical discharge was elderly, white, lived in a private or semiprivate residence with a caregiver to whom they were related, and died while in hospice care. The primary source of payment was Medicare. Most received three or more services, were seen by three or more service providers, received help from the hospice with at least one activity of daily living (ADL), were incontinent, and had mobility limitation. Cancer is the most common primary admission diagnosis, but the proportion decreased from 75 percent in 1992 to 58 percent in 2000. Most of the discharges did not receive timely care. Sixty-three percent of discharges received hospice care for less than 30 days. The average length of service was 46.9 days, and the median length of service was 15.6 days. Shorter lengths of service occurred for those who were living in institutions, did not receive help from the agency with ADLs, had a lower level of mobility limitation, and had a primary admission diagnosis of cerebrovascular disease. Of the noninstitutionalized discharges, those whose primary caregiver was a spouse had shorter lengths of service than those who were cared for by a child.
为了从临终关怀中获得最大益处，一个人应接受至少30天的临终关怀服务。对许多美国人来说，这一目标并未实现。本报告展示了2000年临终关怀出院的数据，还呈现了选定的趋势数据。
数据来自国家家庭和临终关怀调查。所展示的数据是按选定的出院特征划分的数量和百分比。服务时长指标包括平均和中位数服务时长以及服务间隔时长。
2000年有621,100例临终关怀出院病例。典型的出院患者为老年人，白人，居住在有亲属照料的私人或半私人住所，并在临终关怀期间去世。主要支付来源是医疗保险。大多数患者接受了三种或更多服务，由三个或更多服务提供者诊治，在至少一项日常生活活动（ADL）方面得到临终关怀机构的帮助，大小便失禁，且行动受限。癌症是最常见的主要入院诊断，但这一比例从1992年的75%降至2000年的58%。大多数出院患者未得到及时护理。63%的出院患者接受临终关怀服务的时间不足30天。平均服务时长为46.9天，中位数服务时长为15.6天。居住在机构中的患者、未在ADL方面得到机构帮助的患者、行动受限程度较低的患者以及主要入院诊断为脑血管疾病的患者，其服务时长较短。在非机构化出院患者中，主要照料者为配偶的患者的服务时长比由子女照料的患者短。
