Patients with cancer referred to hospice versus a bridge program: Patient characteristics, needs for care, and survival

Purpose: The purpose of this study was to compare the characteristics and n eeds of patients with advanced cancer who were referred to hospice with tho se referred to a prehospice "bridge" program that is staffed by hospice nur ses. Patients and Methods: Data were gathered through retrospective review of co mputerized clinical records using preceded data fields of 284 patients with cancer enrolled in a bridge program and 1,000 who enrolled in a hospice pr ogram, Patient characteristics, needs for supportive care at the time of en rollment, and survival were assessed. Results: Bridge patients were less likely to have Medicare or Medicaid (43% v 72%; odds ratio, 0.30; P < .001) and were younger (69 v 73 years, rank s um test; P < .001), more likely to be married (59% v 43%; odds ratio, 1.90; P < .001), and more likely to be in the highest income category (14% v 10% ; odds ratio, 1.77 P = .009). Bridge patients had at least as many needs fo r care as did patients in hospice, Bridge patients lived significantly long er (median, 46 v 19 days; log-rank test of survivor functions, P < .001). Conclusion: Patients referred to this bridge program had prognoses that are significantly better than those of patients who enter hospice, but they ha ve needs for supportive care that are at least as great. These findings und erscore the importance of initiatives to extend some of the benefits of hos pice care to a wider population of patients and should encourage the analys is of similar programs' ability to meet these needs. (C) 2001 by American S ociety of Clinical Oncology.