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.
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.
Authors: Colleen L Barry; Melissa D A Carlson; Jennifer W Thompson; Mark Schlesinger; Ruth McCorkle; Stanislav V Kasl; Elizabeth H Bradley Journal: Med Care Date: 2012-07 Impact factor: 2.983
Authors: Maureen E Canavan; Melissa D Aldridge Carlson; Heather L Sipsma; Elizabeth H Bradley Journal: J Palliat Med Date: 2013-07-30 Impact factor: 2.947
Authors: Melissa D Aldridge; Mark Schlesinger; Colleen L Barry; R Sean Morrison; Ruth McCorkle; Rosemary Hürzeler; Elizabeth H Bradley Journal: JAMA Intern Med Date: 2014-04 Impact factor: 21.873
Authors: Melissa D A Carlson; Colleen Barry; Mark Schlesinger; Ruth McCorkle; R Sean Morrison; Emily Cherlin; Jeph Herrin; Jennifer Thompson; Martha L Twaddle; Elizabeth H Bradley Journal: Med Care Date: 2011-09 Impact factor: 2.983
Authors: Meagan E Cea; M Cary Reid; Charles Inturrisi; Lisa R Witkin; Holly G Prigerson; Yuhua Bao Journal: J Pain Symptom Manage Date: 2016-09-29 Impact factor: 3.612