Editorial Discharge From Hospice: Dead or Alive?

Discharged alive, withdrawal, or disenrolling from hospice are all the terms that have been used to describe patients that stop using the hospice benefit. The estimates of this occurrence vary widely from 6 % to 15%1,2 as are the reasons: male, unmarried, less than age 65, noncancer diagnosis, lacking a do-not-resuscitate order, intravenous access, and symptoms requiring intervention3; noncancer diagnosis, good functional status but not age4; newer hospices, smaller hospices, and hospices in compet-itive markets5; improved or stabilized conditions, patient or family deciding to withdrawal, and seeking aggressive treatment.6 Within this background, Carlson et al1 investigated this issue in patients with cancer enrolled in hospice. Specifically, they ana-lyzed data from 90 826 patients in 1384 hospices in the linke