Are Neurologists Aware of Neurology-Specific Hospice Criteria?
The aging population has led to an increasing neurological disease burden. Neurology-specific criteria for hospice exist but awareness and utilization rates are not well-known. We surveyed neurology trainees and faculty at a single academic medical center regarding their awareness and familiarity with neurology-specific hospice criteria.
An anonymous online survey was sent to PGY 2-4 neurology residents and faculty at the Department of Neurology across Los Angeles County + University of Southern California Medical Center and Keck Medical Center. The questionnaire asked if the provider was aware of any neurology-specific hospice criteria (yes/no) for major neurological conditions. They were also asked how often they discussed eligibility for hospice when indicated (5-point Likert scale; Never, Rarely, Sometimes, Often, Always) and how familiar they were with any staging/performance scales for hospice (not at all, slightly, somewhat, moderately, extremely). Proportions of answers were recorded.
22 out of 65 (33.8%) providers responded to the survey. 63.6% were faculty. 40.9% were aware of any neurology-specific hospice criteria. Top 5 conditions that providers thought had hospice criteria used by Centers for Medicare & Medicaid Services were Amyotrophic Lateral Sclerosis (86.4%), Alzheimer’s Dementia (68.2%), Parkinson’s Disease (63.6%), Stroke (45.5%), and Muscular Dystrophy (45.5%). 22.7% of providers often or always initiated discussion on hospice when indicated. 9.1% were moderately or extremely familiar while 68.2% were not at all familiar with any staging or performance scales for hospice.
Less than half of Neurology trainees and faculty were aware of any neurology-specific hospice criteria while less than one tenth were at most moderately familiar with any staging or performance scales for hospice. A larger study is needed to determine the familiarity and utilization hospice screening tools. Dedicated educational tools for neurologists can be useful.