Concurrent Hospice in a Veteran's Affairs Dialysis Unit: A Single Center Experience and Lessons Learned over 4 Years

Am J Hosp Palliat Care. 2024 Nov 19:10499091241301754. doi: 10.1177/10499091241301754. Online ahead of print.

Abstract

End stage kidney disease (ESKD) patients until recently have been effectively excluded from receiving hospice benefits unless they withdraw from renal replacement therapy. Policy change has allowed select populations to receive concurrent hospice and hemodialysis. We conducted a retrospective analysis of all deaths occurring from 2019 to 2022 among outpatient hemodialysis patients at our VA medical center. We compared clinical data and resource utilization between patients that were enrolled in concurrent hospice vs patients that were not enrolled in hospice. Our data suggests that among the hemodialysis population, enrollment in concurrent hospice services was not associated with increased healthcare resource utilization. This information may help increase enrollment in hospice among dialysis patients and promote optimal end of life care.

Keywords: end of life care; end stage kidney disease; hemodialysis; hospice; resource utilization; veterans.