Language

English

Publication Date

6-1-2026

Journal

Health Affairs

DOI

10.1377/hlthaff.2025.01218

PMID

42224614

PMCID

PMC13394011

PubMedCentral® Posted Date

7-24-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Medicare beneficiaries frequently visit the emergency department (ED) at the end of life, but little is known about the epidemiology of patients admitted to hospice from the ED. We used 100 percent Medicare fee-for-service claims from the period 2018-20 to describe the frequency of direct ED-to-hospice enrollments, associated patient and hospice agency characteristics, and patient outcomes. In this sample, 4.3 percent of initial enrollments in hospice originated from the ED. ED-to-hospice admissions featured short lengths-of-stay (21.7 percent were two days or less) and high rates of general inpatient level of care at the time of enrollment (23.6 percent). The 10 percent of hospice agencies with the highest proportion of ED-to-hospice enrollments were less often for-profit than agencies ranked below the fiftieth percentile in respect to proportion of ED-to-hospice enrollments. Further research is needed to increase understanding of how much patients benefit from ED-to-hospice transfers when their hospice stays before death are very short, and what drivers lead to these ED-to-hospice transfers.

Keywords

Humans, United States, Emergency Service, Hospital, Medicare, Emergency Room Visits, Hospice Care, Female, Male, Aged, Patient Admission, Length of Stay, Aged, 80 and over, Hospices

Published Open-Access

yes

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