Inpatient Discharges to Home Hospice and Facility Hospice Care in California
In 2023, there were 56,183 hospitalizations that led to a discharge to hospice care in California, representing 1.7 % of all discharges (excluding the discharge of newborn babies).
Why is Hospice Important?
Many Americans have expressed a preference for dying in their own home at the end of their life. Hospice provides patients with reliable, comfort-based care while avoiding extreme medical costs and frequent or invasive treatments. It is important to look at the patterns of home and facility-based hospice to understand how patients use these services and how they can better serve individual needs.
Key Findings
- Overall in 2023: 76 percent of patients discharged to hospice care in 2023 were placed in home hospice compared to facility hospice.
- Timeseries: From 2018-2023, there was an upward trend in patients discharged to hospice care (an approximate 12 percent increase).
- Age: In 2023, about 54 percent of total discharges to hospice care were patients aged 70-89.
- Race/Ethnicity: In 2023, Hispanic patients discharged to hospice were more likely to be placed in home hospice than patients of any other race/ethnicity group while Asian/Pacific Islander patients discharged to hospice were the most likely to be placed in facility hospice.
- Assigned Sex at Birth: About 53 percent of patients discharged to hospice in 2023 were female.
- Payer: About 79 percent of patients discharged to hospice in 2023 had Medicare as their primary payer.
- Diagnosis Category: From 2018-2023, patients with a stroke/cardiovascular accident diagnosis had the highest percentage of discharges to facility hospice care compared to other diagnosis categories.
Visualization
How HCAI Created This Product
The Inpatient Discharges to Home and Facility Hospice Care in California report was created using HCAI’s Patient Discharge Data (PDD) for the years 2018 – 2023. Only records for discharges to either home or facility-based hospice are included; these were identified through the disposition variable in the PDD.
Race/Ethnicity: Individuals whose race is “Other Race”, unknown, as well as invalid and missing values, are included in the “Other/Unknown (Other/Unk)” category. Individuals whose ethnicity is Hispanic or Latino were assigned to the “Hispanic” category regardless of race. Individuals identified as Native Hawaiian or Other Pacific Islander were assigned to the “Asian/Pacific Islander (Asian/PI)” category along with individuals identified as Asian. All other race groups were placed into their own separate category.
Payer Type: Workers’ Compensation, Other Government, County Indigent Programs, Other Indigent, and Other Payer, as well as invalid and missing values, are included in the “All Other” category. All other expected payer types were placed into their own separate category.
The diagnosis categories were created by organizing Medicare Severity Diagnosis Related Group (MS-DRG) codes into distinct groups.
Glossary
| Terms | Definitions |
|---|---|
| Payer Type | The payer type that was expected to pay the greatest share of the patient’s bill at the time of discharge, not the payer type that actually paid. |
| Medi-Cal | A public health insurance program that provides free or low-cost medical services and healthcare benefits to low-income individuals, financed from state and federal funds; California’s version of Medicaid. Includes Medi-Cal Managed Care and Medi-Cal Fee-for-Service. |
| Medicare | A federal health insurance program funded by the Centers for Medicare & Medicaid Services (CMS) under the Social Security Amendments of 1965 that provides healthcare benefits to those aged 65 years and over and to disabled beneficiaries of any age. Includes Medicare Advantage and Medicare Fee-for-Service (Traditional Medicare). |
| Private | Coverage by a private, non-profit or commercial health plan or through an organization. Includes individual coverage purchased through Covered California and payments by charitable organizations. |
| Self-Pay | Coverage where payments are made directly by the patient, a personal guarantor, relatives or friends. In self-pay coverage, the greatest share of the patient’s bill is not paid by any other form of insurance or health plan. |
| All Other | All payers who do not belong in any of the other categories. This includes Worker’s Compensation, County and Other Indigent, Other Government, Other Payer, Invalid or Missing. |
Additional Information
Topic: Healthcare Utilization
Source Link: Healthcare Utilization – Inpatient Discharges
Citation: HCAI — Patient Discharge Data – Hospice Utilization – Patient Demographics, 2018–2023
Temporal Coverage: 2018–2023
Spatial/Geographic Coverage: Statewide, County
Frequency: Annually