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Identifying hospice-appropriate nursing home residents for physicians increased hospice referrals and enrolment

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 Q Does promoting communication about hospice care between physicians and their patients in nursing homes increase hospice use?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Geriatrics ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:

{not concealed*}.

Embedded ImageBlinding:


Embedded ImageFollow up period:

6 months or death.

Embedded ImageSetting:

3 nursing homes in Philadelphia, Pennsylvania, USA. All 3 homes had existing hospice programmes or relationships with community hospice programmes.

Embedded ImagePatients:

205 nursing home residents (mean age 84 y, 75% women) and their surrogate decision makers. Exclusion criteria were admission for respite, already receiving hospice care, or inability to complete the interview because of cognitive impairment and no available surrogate.

Embedded ImageIntervention:

all residents and/or surrogates were read scripted interview questions to assess the resident’s appropriateness for hospice care. Residents were deemed appropriate for hospice care if either the resident or surrogate (1) expressed goals for …

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  • * See glossary.

  • Information provided by author.

  • For correspondence: Dr D Casarett, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA. casarett{at}

  • Source of funding: Paul Beeson Physician Faculty Scholars Award.

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