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Claims data
are used for a variety of purposes, including studying the care
received by dying patients. The remainder of this chapter focuses
on studying patients in hospice using administrative data. Hospice
is particularly useful because it is a specific, fairly well-defined,
service. In contrast, "end-of-life care" is somewhat
ambiguous because some services (e.g. pain management) may or
may not be "end-of-life care" depending on the physical
status of the patient. However, there is no difference in appropriateness,
payment rate, or codes used to distinguish between pain management
in end of life care settings and general pain management.
End-of-life
care, palliative care, and hospice are three inter-related terms.
Hospice care describes specific services and a particular model
of care. Palliative care is the broad term describing care aimed
at symptom control (i.e. palliation) rather than cure of disease.
End-of-life care is care provided to patients in their last days,
weeks or months of life. Such care may or may not include palliative
care and includes hospice care for about 20% of elderly dying
(Virnig, 2000) and for about
50% of patients dying of cancer (Virnig,
2002).
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