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Hospice care for patients with dementia: does volume make a difference?
Susan C Miller1, Dan K Kiely, Joan M Teno
1Center for Gerontology & Health Care Research, Department of Community Health, The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA. susan_miller@brown.edu
Journal of Pain and Symptom Management
|January 25, 2008
Summary
Hospices caring for more dementia patients reported lower overall excellent care ratings. Profit status influenced dementia care quality outcomes, highlighting the need for further research into patient satisfaction.
Area of Science:
- Gerontology
- Health Services Research
- Palliative Care
Background:
- Quality of care in hospice settings is crucial for patient and family satisfaction.
- Understanding factors influencing hospice quality, such as patient population, is essential.
- Previous research has not fully explored the impact of a high proportion of dementia patients on hospice care quality.
Purpose of the Study:
- To investigate the relationship between the proportion of dementia patients in hospice care and reported quality of care by bereaved family members.
- To examine if hospice profit status modifies this relationship.
Main Methods:
- Utilized 2005 Family Evaluation of Hospice Care data from 396 eligible hospices.
- Categorized hospices based on the percentage of decedents with dementia (<13%, 13%-19%, >=19%).
- Conducted stratified analyses by for-profit and not-for-profit status.
Main Results:
- For-profit hospices with >=19% dementia patients reported lower unmet pain needs compared to those with <13%.
- Both for-profit and not-for-profit hospices with >=19% dementia patients reported fewer 'excellent' care ratings.
- No significant associations were found for other outcomes, though trends favored for-profit hospices.
Conclusions:
- Hospice profit status moderates the association between the volume of dementia care and quality ratings.
- Higher proportions of dementia patients may be linked to lower overall excellent care ratings, warranting further investigation.
- There is a need to examine hospice quality outcomes, particularly considering profit status and patient population diversity.
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