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Many Dying Patients Do Not Get Hospice Care

NEW YORK (Reuters Health) - Although hospice care has been promoted as a way to help patients die with less pain and more peace, many doctors do not refer dying patients to hospice centers, new research shows.
Hospice care focuses not on curing a disease, but on relieving symptoms and making dying patients as comfortable as possible in their last months or days of life. But many people who are eligible for hospice care may not be getting it, according to a report in the December 22nd issue of the Journal of Palliative Care.

A survey of 231 Connecticut doctors reveals that about 55% of their terminally ill patients have been referred for hospice care. In addition, 27% of physicians said they refer fewer than one quarter of their dying patients. Dr. Elizabeth H. Bradley of the Yale University School of Medicine in New Haven, Connecticut, led the study.

Earlier research has shown that only around half of patients who could use hospice care actually get it. Bradley's team sought to uncover the reasons for these referral rates. They found that while doctors often indicated that patients or their families refused hospice referrals, many doctors also showed a less-than-complete understanding of hospice care, as measured on an objective knowledge scale.

Moreover, doctors who were more knowledgeable about hospice care were more likely to refer patients. "Educational efforts with physicians that focus on fundamental facts about hospice eligibility and benefit rules," the researchers write, "may enhance referrals for hospice when appropriate."

SOURCE: Journal of Palliative Care.