Impact of the COVID-19 Pandemic on the Utilization of Hospice Care Services: A Cohort Study in Taiwan.
CONTEXT
Hospice care focuses on improving the quality of end-of-life care and respecting patients' preferences regarding end-of-life treatment. The impact of coronavirus disease 2019 (COVID-19) on the utilization of hospice services is unknown.


OBJECTIVES
To investigate the utilization of hospice care services before and during the COVID-19 pandemic.


METHODS
All patients (n = 19,900) cared for at Taipei City Hospital from January 2019 to April 2020 were divided into three time points: January-April 2019 (before COVID-19), May-December 2019 (interim), and January-April 2020 (during COVID-19). This cohort study compared the monthly utilization of hospice services before and during the COVID-19 pandemic.


RESULTS
There was no significant difference in hospice home visits (194 vs. 184; P = 0.686) and new enrollments (15 vs. 14; P = 0.743) to hospice home care before and during the pandemic. However, the bed occupancy rate in hospice units in the hospital was significantly reduced from 66.2% before the pandemic to 37.4% during the pandemic (P = 0.029), whereas that in nonhospice units had a nonsignificant decrease from 81.6% before the pandemic to 71.8% during the pandemic (P = 0.086). During the pandemic, the number of inpatient days was affected more severely in hospice units than in nonhospice units (-42.4% vs. -10.9%; P = 0.029).


CONCLUSIONS
This study suggests that hospice home care services were maintained during the COVID-19 pandemic, while the utilization of hospice inpatient care services reduced. Home care for hospice patients is an essential component of palliative care during a pandemic.
['Chou|Yi-Chang|YC|', 'Yen|Yung-Feng|YF|', 'Feng|Rung-Chuang|RC|', 'Wu|Meng-Ping|MP|', 'Lee|Ya-Ling|YL|', 'Chu|Dachen|D|', 'Huang|Sheng-Jean|SJ|', 'Curtis|J Randall|JR|', 'Hu|Hsiao-Yun|HY|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000073640:Betacoronavirus D000086382:COVID-19 D015331:Cohort Studies D018352:Coronavirus Infections D000078336:Facilities and Services Utilization D005260:Female D006699:Home Care Services D017051:Hospice Care D006801:Humans D007902:Length of Stay D008297:Male D008875:Middle Aged D058873:Pandemics D011024:Pneumonia, Viral D000086402:SARS-CoV-2 D013624:Taiwan
COVID-19 pandemic hospice care service cohort study