"Longer periods of hospice service were associated with decreased end-of-life expenditures for patients residing in regions with high average expenditures but not for those in regions with low average expenditures," the researchers wrote.
Regional Care Differences
The way physicians practice medicine likely is a key factor in determining the economic impact of hospice care utilization, they determined.
"It is well established that physicians in different geographic regions practice differently. For example, physicians practicing in high-expenditure regions may be more likely than those in low-expenditure regions to recommend discretionary services for which strong evidence is lacking, and to test and treat patients intensively."
In contrast, the economic benefit of hospice care was found to be limited in regions of the country where the practice of medicine is more tight-fisted.
In these regions, increased hospice utilization generated a relatively low economic offset to inpatient and outpatient care at hospital settings, the researchers wrote.
"Whether or not hospice use results in cost savings is determined by the offset between the increase in hospice expenditures and the decrease in inpatient or outpatient expenditures."
Healthcare Policy Implications
While research has shown that hospice care has benefits for patients with terminal conditions, the study found that the economic benefits of hospital care vary regionally.
Incentivizing hospice care and launching hospice educational efforts in regions with high medical costs could have a dramatic impact on total U.S. healthcare expenditures, according to the study.
"Such targeted cost-saving measures may provide substantial economic benefits on a national scale, given that intense end-of-life care expenditures constitute a significant proportion of annual Medicare expenditures."
Christopher Cheney is the senior clinical care editor at HealthLeaders.