• Helen P Knight, Caitlin Brennan, HurleySusan LysaghtSLCare Dimensions Inc. (C.B., S.L.H.), Boston, Massachusetts., Anna J Tidswell, Melissa D Aldridge, Kimberly S Johnson, Edo Banach, James A Tulsky, Gregory A Abel, and Oreofe O Odejide.
• Department of Psychosocial Oncology and Palliative Care (H.P.K., J,A,T.), Dana-Farber Cancer Institute, Boston, Massachusetts.
• J Pain Symptom Manage. 2024 Jan 1; 67 (1): 191-9.

ContextPatients with blood cancers have low rates of hospice use. While lack of transfusion access in hospice is posited to substantially contribute to these low rates, little is known about the perspectives of hospice providers regarding transfusion access in hospice.ObjectivesTo characterize hospice providers' perspectives regarding care for patients with blood cancers and transfusions in the hospice setting.MethodsIn 2022, we conducted a cross-sectional survey of a sample of hospices in the United States regarding their experience caring for patients with blood cancers, perceived barriers to hospice use, and interventions to increase enrollment.ResultsWe received 113 completed surveys (response rate = 23.5%). Of the cohort, 2.7% reported that their agency always offers transfusions, 40.7% reported sometimes offering transfusions, and 54.9% reported never offering transfusions. In multivariable analyses, factors associated with offering transfusions included nonprofit ownership (OR 5.93, 95% CI, 2.2-15.2) and daily census >50 patients (OR 3.06, 95% CI, 1.19-7.87). Most respondents (76.6%) identified lack of transfusion access in hospice as a barrier to hospice enrollment for blood cancer patients. The top intervention considered as "very helpful" for increasing enrollment was additional reimbursement for transfusions (72.1%).ConclusionIn this national sample of hospices, access to palliative transfusions was severely limited and was considered a significant barrier to hospice use for blood cancer patients. Moreover, hospices felt increased reimbursement for transfusions would be an important intervention. These data suggest that hospice providers are supportive of increasing transfusion access and highlight the critical need for innovative hospice payment models to improve end-of-life care for patients with blood cancers.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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