Physician Characteristics Strongly Predict Patient Enrollment In Hospice.
Individual physicians are widely believed to play a large role in patients' decisions about end-of-life care, but little empirical evidence supports this view. We developed a novel method for measuring the relationship between physician characteristics and hospice enrollment, in a nationally representative sample of Medicare patients. We focused on patients who died with a diagnosis of poor-prognosis cancer in the period 2006-11, for whom palliative treatment and hospice would be considered the standard of care. We found that the proportion of a physician's patients who were enrolled in hospice was a strong predictor of whether or not that physician's other patients would enroll in hospice. The magnitude of this association was larger than that of other known predictors of hospice enrollment that we examined, including patients' medical comorbidity, age, race, and sex. Patients cared for by medical oncologists and those cared for in not-for-profit hospitals were significantly more likely than other patients to enroll in hospice. These findings suggest that physician characteristics are among the strongest predictors of whether a patient receives hospice care-which mounting evidence indicates can improve care quality and reduce costs. Interventions geared toward physicians, both by specialty and by previous history of patients' hospice enrollment, may help optimize appropriate hospice use.
['Obermeyer|Ziad|Z|', 'Powers|Brian W|BW|', 'Makar|Maggie|M|', 'Keating|Nancy L|NL|', 'Cutler|David M|DM|']
D000368:Aged D000369:Aged, 80 and over D005260:Female D017051:Hospice Care D006801:Humans D016015:Logistic Models D008297:Male D006278:Medicare D009369:Neoplasms D010817:Physician-Patient Relations D010820:Physicians D011787:Quality of Health Care D013727:Terminal Care D013997:Time Factors D014481:United States
Elderly Variations