Discussions With Physicians About Hospice Among Patients With Metastatic Lung Cancer

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Abstract
Hospice includes a broad array of palliative and supportive services that can improve symptom management and quality of life for patients with a terminal illness.1,2 To be eligible for the Medicare hospice benefit, which covers 80% of hospice stays,3 a physician must certify that a patient has a prognosis of 6 months to live or less, and the patient must generally forego life-extending treatments for the illness. Despite the potential benefits of hospice, many terminally ill patients receive hospice services only in the final days before death or never enroll.4,5 Factors that may contribute to late or no enrollment include a lack of awareness of hospice, inaccurate understanding of one's prognosis, or a preference for aggressive treatment of the illness until all nonpalliative options are exhausted.6-11