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March 28, 2019

Hospice and Anticancer Therapy—Shifting From an Either/or to a Both/and Treatment Model

Author Affiliations
  • 1Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Department of Radiation Oncology, Dana-Farber Brigham and Women’s Cancer Center, Boston, Massachusetts
JAMA Oncol. 2019;5(6):786-787. doi:10.1001/jamaoncol.2019.0079

Hospice is specialized interdisciplinary care for persons with terminal illness that—in contrast to the medical goals of curing or slowing disease—aims to uphold quality of life by addressing the physical, psychosocial, and spiritual aspects of illness. The hospice movement began more than 50 years ago when Dame Cicely Saunders created the first modern hospice center in 1967, at St Christopher’s Hospice in London. In the United States, the Medicare Hospice Benefit was established in 1982, providing hospice coverage to Medicare beneficiaries who have life expectancies of 6 months or less and have decided to forgo curative treatments. The US health care insurance plans have adopted similar coverage models, including hospice coverage for veterans with terminal illness by the US Veterans Affairs (VA) in 1991. In the ensuing decades, hospice care has grown in scope. In the United States, an estimated 1.7 million patients received hospice services in 2014, and 43% of Medicare decedents in 2013.1

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