Public Health Research

Home health care linked to increased hospice use 

Findings suggest that early home health care may facilitate access to hospice care, resulting in greater comfort and support for individuals facing end-of-life decisions.

a health care provider with a patient and their partner sitting on a couch

By Kathryn Stroppel

Home health care use in the last three years of a patient’s life is associated with a higher likelihood of home-based, personalized hospice care at the end of life, according to findings published in the Journal of Palliative Medicine, which examined the home health care and hospice care experiences of more than 2 million people.

OSU College of Health Research Assistant Professor Hyosin (Dawn) Kim is first author of the study, which was a collaboration with Rutgers University researchers.

Using Medicare data, researchers found when individuals received home health care before the last year of their life, they had higher odds of using hospice care than those who had never received home health care. Researchers said this association underscores the potential benefits of receiving end-of-life care in the comfort of one’s home.

“By providing personalized care, reducing hospitalizations, fostering family involvement and support, and improving symptom management, home-based care can enhance the quality of end-of-life experiences for patients with terminal illnesses and their families,” Dawn says.

As the older population increases, the findings also show the need for more resources in the health care sector and staff training in end-of-life care.

Home health care services including skilled nursing, therapy, social work and aide services are used to maintain functioning or slow decline in health. Hospice care provides similar services but is intended for those with life expectancies of six months or less and is focused on pain relief, minimizing hospital visits and providing comfort and support. Both services provide patients the opportunity to receive more personalized care in their home.

Researchers say home-based care also encourages greater involvement of family caregivers in the caregiving process.

Coauthors of the study include Paul Duberstein of the Rutgers School of Public Health, Haiqun Lin of the Rutgers School of Nursing, Bei Wu of New York University Rory Meyers College of Nursing and Anum Zafar of the Rutgers Institute for Health, Health Care Policy and Aging Research.

This research was supported by National Institutes of Health’s National Institute on Aging, grant R01AG066139.