Indiana University researchers studied 10 years of data for hospice use among nursing home residents. The portion of noncancer patients increased over time, length of hospice stay remained high, and over 90% of patients had three or more comorbid diagnoses. Nearly 20% had hospice stays longer than six months and were more likely to discharge before death. It was not easy to predict the clinical course of hospice users, pointing to a need for supporting multiple approaches of palliative care delivery. (Free abstract only.)

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