Those electing full code status on admission to hospice are at high risk of live hospice discharge after short enrollments, particularly nonwhite enrollees.
This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.
(4 were excluded because of missing data) identified 1,466 medication decisions (mean¼15.3 decisions per discharge summary) of which 441 (30%) were to continue medications without changes, 103 (7%) were to continue medications but with changes, 458 (31%) were to start new medications, and 464 (32%) were to discontinue existing medications. Among medications that were initiated or changed, morphine was the most frequent new medication (7%) and aspirin was the most frequently discontinued medication (5%). Only 38% of medication changes had a documented rationale for the change. Conclusion. Medication changes are common on discharge to hospice and frequently lack documentation of the rationale for these changes.
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