Table 1.
Comparison of Nursing Home Decedents According to Matching Group.*
| Characteristic | Hospice Group (Group 2)† | Nonhospice Group (Group 3)† | ||||
|---|---|---|---|---|---|---|
| G22004 (N = 72,391) | G22009 (N = 72,391) | Standardized Difference‡ | G32004 (N = 216,658) | G32009 (N = 216,658) | Standardized Difference‡ | |
| Age at death (yr) | 85.9 | 86.0 | 1.2 | 85.2 | 85.4 | 2.1 |
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| Male sex (%) | 30.9 | 32.0 | 2.4 | 36.0 | 37.4 | 2.9 |
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| Nonwhite race (%) | 8.9 | 10.3 | 4.6 | 11.0 | 12.3 | 4.1 |
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| Married (%) | 23.1 | 24.2 | 2.7 | 25.4 | 26.6 | 2.7 |
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| Cancer and no dementia (%) | 13.7 | 14.2 | 2.1 | 13.4 | 13.7 | 1.0 |
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| Cancer and dementia (%) | 11.2 | 12.2 | 3.2 | 7.9 | 8.3 | 1.5 |
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| Dementia and no cancer (%) | 52.2 | 52.1 | −0.4 | 44.7 | 45.2 | 1.0 |
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| No cancer and no dementia (%) | 22.9 | 21.5 | −3.5 | 34.0 | 32.8 | −2.7 |
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| Emphysema or chronic obstructive pulmonary disease (%) | 30.5 | 32.2 | 3.6 | 35.1 | 36.3 | 2.5 |
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| Congestive heart failure (%) | 46.6 | 44.5 | −3.6 | 52.6 | 50.9 | −3.5 |
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| Diabetes (%) | 25.3 | 29.4 | 9.1 | 28.4 | 32.7 | 9.4 |
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| Arteriosclerotic heart disease (%) | 15.4 | 15.6 | 0.7 | 16.1 | 16.9 | 2.0 |
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| Peripheral vascular disease (%) | 13.0 | 13.4 | 1.1 | 13.5 | 13.9 | 1.2 |
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| Cerebrovascular accident (%) | 22.5 | 19.7 | −7.0 | 22.3 | 19.5 | −7.0 |
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| Depression (%) | 43.1 | 48.4 | 10.4 | 36.2 | 40.5 | 8.9 |
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| Asthma (%) | 2.5 | 3.2 | 3.4 | 2.5 | 3.1 | 3.9 |
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| Pneumonia (%) | 9.5 | 9.1 | −1.1 | 13.2 | 13.2 | −0.2 |
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| Respiratory infection (%) | 3.9 | 3.2 | 3.5 | 4.3 | 3.7 | −3.1 |
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| Septicemia (%) | 1.4 | 1.5 | 0.5 | 2.2 | 2.3 | 0.3 |
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| CPS score§ | 3.66 | 3.45 | −11.4 | 3.29 | 3.09 | −10.8 |
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| ADL score¶ | 22.0 | 21.8 | −2.9 | 21.1 | 21.1 | −0.5 |
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| ADL score worsening since last MDS (%) | 27.3 | 25.8 | −2.9 | 16.4 | 14.5 | −5.3 |
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| Do-not-hospitalize orders (%) | 8.1 | 9.2 | 4.1 | 6.5 | 7.4 | 3.8 |
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| Do-not-resuscitate orders (%) | 77.0 | 77.4 | 0.8 | 66.9 | 66.4 | −1.1 |
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| Nursing home stay <30 days (%) | 7.3 | 6.9 | −1.1 | 17.9 | 16.7 | −3.2 |
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| Nursing home stay >90 days (%) | 80.5 | 80.3 | −1.3 | 64.0 | 64.3 | 0.7 |
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| Time from last MDS to death (days) | 34.6 | 34.1 | −2.0 | 25.7 | 25.2 | −1.7 |
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| No. of hospitalizations in the year before the year of death | 0.72 | 0.76 | 3.8 | 0.68 | 0.72 | 3.3 |
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| Mean hospital length of stay (days) | 2.20 | 2.17 | −0.8 | 2.15 | 2.10 | −1.3 |
ADL denotes activities of daily living, CPS Cognitive Performance Scale, and MDS Minimum Data Set.
Group G22004 includes non–hospice users in 2004 considered likely to have used hospice if they had died in 2009. Group G22009 includes hospice users in 2009 considered likely not to have used hospice if they had died in 2004. Groups G32004 includes non–hospice users in 2004 who were considered likely to continue not to use hospice if they had died in 2009, and Group G32009 includes non–hospice users in 2009. Because matching was done with replacement, some persons in 2004 were selected as matches for more than one person in 2009. The number of unique persons in the two 2004 groups was 58,427 for the hospice group and 139,351 for the nonhospice group. The results in the table for the 2004 groups of matched persons are based on weighted individuals so that 2004 and 2009 have same matched sample size. See the Supplementary Appendix for further details.
Standardized differences are defined as 100 × (mean1 − mean0) ÷ [(variance1+ variance0) ÷ 2]1/2, where 1 is the 2009 subgroup and 0 is the (matched) 2004 subgroup. The range is from −100 to 100. Some studies have used a standardized difference of less than 10 percentage points (in absolute value) to indicate a negligible difference,19 but no precise agreement exists.17 For characteristics expressed as percentages, standardized differences are given as percentage points.
The CPS score ranges from 0 (intact) to 6 (very severe impairment), with a score of 5 corresponding to a score of 5.1 on the Mini–Mental State Examination (range, 0 to 30; <24 indicates cognitive impairment).
The ADL score ranges from 0 to 28, with higher values reflecting greater impairment in function.