A nurse who provides care on an acute medical unit has observed that physicians are frequently reluctant to refer patients to hospice care. What are contributing factors that are known to underlie this tendency? Select all that apply
A) Financial pressures on health care providers
B) Patient reluctance to accept this type of care
C) Strong association of hospice care with prolonging death
D) Advances in "curative" treatment in late-stage illness
E) Ease of making a terminal diagnosis
Ans: A, B, D
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Physicians are reluctant to refer patients to hospice, and patients are reluctant to accept this form of care. Reasons include the difficulties in making a terminal prognosis (especially for those patients with noncancer diagnoses), the strong association of hospice with death, advances in "curative" treatment options in late-stage illness, and financial pressures on health care providers that may cause them to retain rather than refer hospice-eligible patients.
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