Ownership status and patterns of care in hospice: results from the National Home and Hospice Care Survey.
Background: The number of for-profit hospices increased nearly 4-fold over the past decade, more than 6 times the growth of nonprofit hospices. Despite this growth, the impact of ownership on hospice care is largely unknown. We sought to assess differences in the provision of services to patients of...
| Published in: | Medical Care Vol. 42; no. 5; pp. 432 - 439 |
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| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Lippincott Williams & Wilkins
May2004
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106668575&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106668575 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00257079 21B jtl: Medical Care issn: 00257079 maglogo: N pubinfo: dt: May2004 vid: 42 iid: 5 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 106668575 106668575 NLM15083103 2004191476 10.1097/01.mlr.0000124246.86156.54 NLM15083103 106668575 ppf: 432 ppct: 7 formats: tig: atl: Ownership status and patterns of care in hospice: results from the National Home and Hospice Care Survey. aug: au: Carlson MDA Gallo WT Bradley EH Carlson, Melissa D A Gallo, William T Bradley, Elizabeth H affil: Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, Connecticut, USA sug: subj: Hospice Care Evaluation Hospices Evaluation Organizations, For Profit Evaluation Organizations, Nonprofit Evaluation Aged Confidence Intervals Cross Sectional Studies Data Analysis Software Data Analysis, Statistical Descriptive Statistics Female Funding Source Male Multiple Logistic Regression Odds Ratio Survey Research Human Aged: 65+ years Female Male ab: Background: The number of for-profit hospices increased nearly 4-fold over the past decade, more than 6 times the growth of nonprofit hospices. Despite this growth, the impact of ownership on hospice care is largely unknown. We sought to assess differences in the provision of services to patients of for-profit and nonprofit hospices.Methods: Using the 1998 National Home and Hospice Care Survey, we examined services used by patients (N = 2080) cared for by 422 hospices nationwide. We used multivariable ordered logistic and logistic regression to assess the effect of profit status on service use, adjusting for potentially confounding patient and organizational characteristics. We calculated point estimates adjusted for sampling weights and standard errors adjusted for the clustering of patients within hospices.Results: In ordered logistic models controlling for organizational and patient factors, patients of for-profit hospices received a significantly narrower range of services (adjusted odds ratio [OR], 0.45; 95% confidence interval [CI], 0.22-0.92) than patients of nonprofit hospices. This result is driven by patients of for-profit hospices receiving significantly fewer types of hospice services that federal regulations term "noncore" or more discretionary services (adjusted OR, 0.34; 95% CI, 0.15-0.75).Conclusion: The pattern of care differs in for-profit and nonprofit hospices. As the industry develops a substantial for-profit presence, it is critical for clinicians and other healthcare professionals to be alert to the potential impact of profit status on the care their patients receive. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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