Differences in hospice care between home and institutional settings.

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• Hospice care is increasingly utilized in the United States.
• Significant growth in hospice utilization has been observed in institutional settings.
• Understanding differences between home and institutional hospice is crucial for quality assessment.

Purpose of the Study:

• To compare hospice care provided in home settings versus institutional settings.
• To analyze recipient characteristics, service utilization, and enrollment lengths across different hospice environments.

Main Methods:

• Utilized secondary data from the National Home and Hospice Care Survey (1994-2000).
• Analyzed nationally representative data on hospice agencies and their patients.
• Adjusted comparisons for demographic factors, health status, and time trends.

Main Results:

• Hospice use has risen, particularly in institutional settings.
• Institutional hospice users were older, more likely female, unmarried, and dually eligible for Medicare and Medicaid.
• Institutional users were more likely to have non-cancer diagnoses and shorter enrollment periods (≤1 week).

Conclusions:

• Significant disparities exist between home and institutional hospice care settings.
• Further research is needed to understand cost implications and quality of care across settings.
• The growing use of institutional hospice necessitates policy evaluation and reform considerations.