Impact of the COVID-19 Pandemic on the Utilization of Hospice Care Services: A Cohort Study in Taiwan

• Published in: Journal of pain and symptom management 2020-09, Vol.60 (3), p.e1-e6
• Main Authors: Chou, Yi-Chang, Yen, Yung-Feng, Feng, Rung-Chuang, Wu, Meng-Ping, Lee, Ya-Ling, Chu, Dachen, Huang, Sheng-Jean, Curtis, J. Randall, Hu, Hsiao-Yun
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Betacoronavirus; Cohort Studies; cohort study; Coronavirus Infections - epidemiology; COVID-19; COVID-19 Fast Tracked; Facilities and Services Utilization; Female; Home Care Services - statistics & numerical data; Hospice Care - statistics & numerical data; hospice care service; Humans; Length of Stay - statistics & numerical data; Male; Middle Aged; pandemic; Pandemics; Pneumonia, Viral - epidemiology; SARS-CoV-2; Taiwan
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2020.07.005

Hospice care focuses on improving the quality of end-of-life care and respecting patients’ preferences regarding end-of-life treatment. The impact of coronavirus disease 2019 (COVID-19) on the utilization of hospice services is unknown. To investigate the utilization of hospice care services before and during the COVID-19 pandemic. All patients (n = 19,900) cared for at Taipei City Hospital from January 2019 to April 2020 were divided into three time points: January–April 2019 (before COVID-19), May–December 2019 (interim), and January–April 2020 (during COVID-19). This cohort study compared the monthly utilization of hospice services before and during the COVID-19 pandemic. There was no significant difference in hospice home visits (194 vs. 184; P = 0.686) and new enrollments (15 vs. 14; P = 0.743) to hospice home care before and during the pandemic. However, the bed occupancy rate in hospice units in the hospital was significantly reduced from 66.2% before the pandemic to 37.4% during the pandemic (P = 0.029), whereas that in nonhospice units had a nonsignificant decrease from 81.6% before the pandemic to 71.8% during the pandemic (P = 0.086). During the pandemic, the number of inpatient days was affected more severely in hospice units than in nonhospice units (−42.4% vs. −10.9%; P = 0.029). This study suggests that hospice home care services were maintained during the COVID-19 pandemic, while the utilization of hospice inpatient care services reduced. Home care for hospice patients is an essential component of palliative care during a pandemic.