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Hospice Use in Medicare Beneficiaries With Cancer
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To the Editor: Dr McCarthy and colleagues1 found that 27% of Medicare beneficiaries with lung cancer had access to hospice services. They also found that the percentage was lower among those patients with Medicare fee-for-service than among those with Medicare managed care.
However, they reported that only 16.4% of patients with breast cancer had access to hospice care. This lesser access does not seem to be explained by sex differences because men with prostate cancer had a similar rate of access (18.1%). The cohort comprised Medicare beneficiaries originally diagnosed as having cancer. This sampling procedure therefore included all terminally ill patients regardless of their clinical scenarios.
However, not all patients diagnosed as having cancer are necessarily terminally ill from it. We recently found that approximately two thirds of women diagnosed as having breast cancer were classified as dying of breast cancer, and that the others were dying with breast cancer . . . [Full Text of this Article]
Bruno Gagnon, MD, MSc
Division of Clinical Epidemiology
McGill University Health Center
Montreal, Quebec
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