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Live Discharge From Hospice

A Systematic Review

Wu, Serena; Volker, Deborah L. PhD, RN, FAAN

Journal of Hospice & Palliative Nursing: December 2019 - Volume 21 - Issue 6 - p 482–488
doi: 10.1097/NJH.0000000000000547
Feature Articles

Live discharges from hospice may occur because of patient choice or provider choice. However, when discharges occur before death, patients and families may feel abandoned and left to manage care needs previously provided by hospice. The purpose of this systematic review was to better understand the nature of live discharges, including frequency, patient characteristics, and hospice characteristics. Of 44 studies identified for review, 13 met inclusion criteria and were published between 2008 and 2018. Live discharge rates varied from 5% to 23%. Patients’ prehospice characteristics varied widely based on diagnosis, comorbidities, gender, race, and ethnicity. Hospice characteristics indicated that the likelihood of a live discharge was increased for patients enrolled in for-profit hospices and in rural areas. Only 2 studies captured the patient/family perspective of the live discharge experience, finding that the loss of hospice support was fraught with difficulties. A need for further study of the live discharge experience and the practices of hospices with high live discharge rates was identified.

Serena Wu, is undergraduate honors BSN student, The University of Texas at Austin School of Nursing.

Deborah L. Volker, PhD, RN, FAAN, is associate professor emerita, The University of Texas at Austin School of Nursing.

Address correspondence to Serena Wu, BSN, 419 Spanish Mustang Dr, Cedar Park, TX 78613 (

The authors have no conflicts of interest to disclose.

Online date: April 8, 2019

© 2019 by The Hospice and Palliative Nurses Association.