Thursday, February 24, 2011

USA For-profit Hospices

For-profit hospices select patients who require less care, study shows

For-profit hospices were also shown to be more likely to have patients without cancer diagnoses and more dementia patients, which require fewer visits from hospice nurses and social workers.

Sixty-three percent of hospices restricted admission on at least one criterion. A significant minority of hospices would not admit patients lacking a caregiver (26%). Patients unwilling to forgo hospitalization could not be admitted to 29% of hospices. Receipt of complex medical care, including TPN (38%), tube feedings (3%), transfusions (25%), radiotherapy (36%), and chemotherapy (48%), precluded admission. Larger program size was significantly associated with a lower likelihood of all admission practices except restricting the admission of patients receiving TPN or tube feedings. Hospice programs that were part of a hospice chain were less likely to restrict the admission of patients using TPN, radiotherapy, or chemotherapy than were freestanding programs.
Conclusion: Patients who are receiving complex palliative treatments could face barriers to hospice enrollment. Policy makers should consider the clinical capacity of hospice providers in efforts to improve access to palliative care and more closely incorporate palliation with other healthcare services.

Journal of the American Geriatrics Society

Journal of the American Geriatrics Society

Volume 52Issue 5pages 725–730May 2004
Nonprofit Hospice Advocacy Group Urges Prompt Action to Address "Cherry Picking" of Patients by For-profit Hospices -

Lorenz, K. A., Asch, S. M., Rosenfeld, K. E., Liu, H. and Ettner, S. L. (2004), Hospice Admission Practices: Where Does Hospice Fit in the Continuum of Care?. Journal of the American Geriatrics Society, 52: 725–730. doi: 10.1111/j.1532-5415.2004.52209.x

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