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...

Full description

Bibliographic Details
Published in:Medical Care Vol. 42; no. 5; pp. 432 - 439
Main Authors: Carlson MDA, Gallo WT, Bradley EH, Carlson, Melissa D A, Gallo, William T, Bradley, Elizabeth H
Format: research tables/charts Journal Article
Published: Lippincott Williams & Wilkins May2004
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