Clinical and socio-demographic profile of hospice admissions: Experience from New Delhi

Abstract

Background: Our hospice caters to referrals from the wide areas in the northern Indian territory. A descriptive analysis of hospice admissions can bring to light, the status of palliative care in the region overall. Aim: The aim was to assess the clinical and demographic profile of hospice admissions in New Delhi during the time period 2016–2017. Methods: Hospice admission records from the calendar year 2016 were digitized from paper charts, and statistical analysis was carried out using SPSS v21. Patient and caregiver demographic profile and dominant referral and utilization patterns were retrospectively assessed. Results: One hundred and fifty-four admissions (mean age 51.8 ± 15 years; 60% females) were recorded. Up to one-third of the patients (48, 31%) were single at the time of admission. Majority of the patients had below 10 th grade literacy level (116, 75.3%) and belonged to low socioeconomic status. Two large tertiary care centers were the most common referrers (54.6%). The top three diagnoses were head-and-neck cancers (56, 36.4%), gastrointestinal cancers (27, 17.5%), and metastatic breast cancer (23, 14.9%). Major patient-reported debilities were pain (73%), dysphagia (51%), and incontinence (45%). The mean duration from diagnosis to hospice referral was 2.7 ± 0.7 years. Majority of the patients (76%) reported to have undergone some form of oncologic treatment. Up to two-thirds of the patients received opioids with or without additional supportive care. Conclusion: Pain, dysphagia, and incontinence were the most common reasons for hospice referral, with incontinence being significantly correlated with the divorced status. There were no differences in the prevalence of other symptoms with relation to the marital status. Data on hospice utilization patterns in India are limited to pilot experiences. More data are needed to drive national-level policies.

Characteristics and Procedures Among Adults Discharged to Hospice After Gastrointestinal Tract Surgery in California

“…Further, our findings reiterate and build on the long-standing disparities around end-of-life care seen elsewhere. Differences in access to hospice care by race and ethnicity, social vulnerability, and insurance status have been established in the literature . Patients in our cohort readmitted after hospice enrollment were less likely to be White, more likely to have limited English proficiency, and more likely to be underinsured, a finding consistent with prior studies .…”

“…Hospice is a component of palliative care intended to optimize quality of life at the end of life using multidisciplinary, team-based care in patients’ preferred settings . In the US, hospice is implemented as an insurance benefit for terminally ill patients whose prognosis for survival is 6 months or less.…”