An Evaluation of the Advanced Illness Management (AIM) Program: Increasing Hospice Utilization in the San Francisco Bay Area

Background: In the Medicare population, end-of-life care is fragmented and hospice is un-derutilized. Evidence suggests that hospice care is associated with increased patient/family satisfaction and reductions in overall health care costs. Advanced Illness Management (AIM) is a home-based program established to ease the transition between curative and comfort care for seriously ill patients who lack coordinated hospital, home health, and hospice care. Objective: Measure the impact of the AIM program on the discharge disposition of partic-ipating home health patients. Design: Retrospective cohort study. Setting/subjects: A total of 435 patients who received home health services through the Sut-ter Visiting Nurse Association and Hospice (SVNA&H) and who were discharged between 2003 and September 2005 were included in this study. Participants were selected based on a life expectancy of 6 months or less and additionally matched on prognosis of current episode of illness and symptom status. Intervention patients were compared to those receiving usual home health care at two SVNA&H branches