Hospice care limited, U.S. report finds

In a new report, the General Accounting Office, an investigative arm of Congress, said that 28 percent of all Medicare beneficiaries in the hospice program received hospice care for one week or less.

William J. Scanlon, director of health care studies at the General Accounting Office, said, "Although more Medicare beneficiaries are receiving hospice services, they are, on the average, receiving fewer days of care than did beneficiaries in the past."

Mr. Scanlon said Medicare patients in the hospice program received an average of 59 days of hospice care in 1998, down 20 percent from an average of 74 days in 1992.

The Senate Special Committee on Aging plans to hold a hearing Monday to investigate the decline. Sen. Charles Grassley, R-Iowa, who is chairman of the committee, said: "Too few people use the hospice benefit for too little time. That has to change."

Hospice care provides a humane alternative for patients who are dying. It emphasizes efforts to relieve pain and suffering, avoids aggressive efforts to cure disease and may allow patients to die in their own homes with their families. Under Medicare, a hospice typically provides doctors' services, nursing care, the services of home health aides, medical supplies, equipment, and pain-control medications.

Medicare finances health care for 39 million people who are elderly or disabled. The number receiving hospice care increased to 358,949 in 1998 from 143,110 in 1992, the accounting office said.

In 1992, more than 75 percent of all Medicare hospice patients had cancer. But the number with other chronic illnesses – heart and lung disease, stroke, Alzheimer's – has increased rapidly. They now account for 43 percent of all Medicare beneficiaries receiving hospice care.