Cost, quality, and satisfaction with hospice after-hours care

Area of Science:

• Healthcare Management
• Nursing Services
• Hospice Care

Background:

• Health maintenance organizations (HMOs) face challenges in providing cost-effective and high-quality after-hours hospice care.
• Evaluating different nursing care models is crucial for optimizing patient outcomes and organizational efficiency.

Purpose of the Study:

• To compare the cost, quality, and patient/family satisfaction of two after-hours nursing care models in a hospice program: in-house nurse employees versus contract nurses.
• To determine the impact of nursing care staffing models on hospice service delivery.

Main Methods:

• A comparative study involving 373 patients in an HMO's hospice program.
• Two distinct after-hours nursing care models were implemented: one utilizing staff nurses and the other utilizing contract nurses.
• Data collected on cost, quality of nursing care (including documentation), and patient/family satisfaction.

Main Results:

• Statistically significant differences were observed between the two nursing care models.
• The in-house nurse employee model resulted in lower hospital day costs for the organization.
• In-house nurses provided better documentation quality, and patients reported higher satisfaction with arrival times, problem understanding, service, information, courtesy, follow-up, and respect.

Conclusions:

• Employing in-house nurses for after-hours hospice care is more cost-effective for HMOs.
• In-house nursing models lead to improved quality of care and higher patient/family satisfaction compared to contract nursing services.
• Optimizing nursing staffing models can enhance overall hospice care delivery and patient experience.