Interdisciplinary staffing patterns: do for-profit and nonprofit hospices differ?

Area of Science:

• Healthcare Management
• Hospice and Palliative Care
• Health Services Research

Background:

• Interdisciplinary care is central to hospice philosophy and quality care delivery.
• Limited understanding exists regarding interdisciplinary staffing variations, especially between nonprofit and for-profit hospice models.
• This study aimed to investigate differences in staffing patterns between for-profit and nonprofit hospices.

Purpose of the Study:

• To examine and compare interdisciplinary staffing patterns in Medicare-certified hospices in the United States.
• To identify specific differences in the composition of professional staff (physician, nursing, psychosocial, home health aide) based on hospice ownership type (nonprofit vs. for-profit).

Main Methods:

• Cross-sectional analysis of the 2006 Medicare Provider of Services (POS) survey data.
• Inclusion of all Medicare-certified hospices operating in the US in 2006.
• Bivariate and multivariable analyses to compare staffing patterns, including the presence of a full interdisciplinary team (defined as at least 1 FTE in each of 4 disciplines) and the professional mix within disciplines.

Main Results:

• For-profit hospices reported a wider range of paid staff but no differences when volunteer staff were included.
• Significant differences were observed in staff proportions: for-profit hospices had proportionally fewer registered nurse FTEs (nursing staff), fewer medical social worker FTEs (psychosocial staff), and fewer clinician FTEs (total staff) compared to nonprofit hospices (p <0.05).
• Both for-profit and government-owned hospices utilized proportionally fewer volunteer FTEs than nonprofit hospices.

Conclusions:

• Hospice staffing patterns exhibit significant variations based on ownership type.
• These identified differences in staffing composition warrant further investigation.
• Future research should explore the impact of these ownership-driven staffing variations on the quality of patient care and family satisfaction within hospice services.