Study Finds Link Between BMI And Hospice Care

Heavy People

A new study has found that the heavier you are, the less likely you are to receive hospice care.

Science Daily reported that the findings, published in the Annals of Internal Medicine, came from researchers at the University of Michigan Institute for Healthcare Policy and Innovation. They analyzed the records of a long-term health study that included more than 5,600 seniors. All of the participants whose records they studied died between 1998 and 2012 and were not living long-term in a nursing home.

The researchers focused on Medicare claims in the last six months of the participants’ lives, looking at use of hospice services and controlling for gender, race, marital status, multiple medical conditions, and household assets. They also had information from surveys of the participants’ loved ones about their end-of-life care. And, they had all participants’ last measured BMI, which is weight in kilograms divided by height in meters squared.

In all, 38 percent of the entire group used hospice services. But the higher a person’s BMI, the lower their chances of getting hospice services. Someone who had a BMI of 40 had less than a 23 percent chance of having hospice services at the end of life, while those in the “normal” weight, with BMI of 20, had a 38 percent chance.

Even among those of any weight who did use hospice services, the number of days spent in hospice was lower among those whose BMIs were higher. The difference stemmed from a stark difference in use of home hospice by heavier people. Nearly 60 percent of the participants died at home — but this percentage dropped the higher a person’s BMI.

John Harris, M.D., M.Sc., who led the study during a fellowship at U-M and is now an assistant professor at the University of Pittsburgh School of Medicine said the specific link between higher BMI and lower access to hospice services still isn’t clear. However, the results show more policy attention should be focused on people with more severe levels of obesity.

“These patients’ voices, and those of their caregivers, need to be heard,” he said. “They may need extra help. They deserve the best healthcare and better health outcomes.”