Related Experiment Videos
Physician reported incentives and disincentives for referring patients to hospice
Insights
Physicians
Area of Science:
- Medical Sociology
- Palliative Care Research
- Qualitative Health Research
Background:
- Physician involvement is crucial for hospice utilization.
- A significant proportion of physicians do not discuss hospice with terminally ill patients.
- Physician selection influences hospice referral patterns.
Purpose of the Study:
- To explore physician-specific factors influencing hospice discussion decisions.
- To understand the qualitative aspects of physician considerations for hospice referrals.
Main Methods:
- Qualitative study employing semi-structured interviews with 17 physicians.
- Thematic analysis of transcribed interview data.
- Categorization of themes into content, incentives, and disincentives.
Main Results:
- Physician's proactive disclosure of terminal diagnoses is a key factor.
- Perception of hospice as facilitating a 'death with dignity' is influential.
- Physician attitudes create an environment conducive to hospice discussions.
Conclusions:
- Physician's approach to end-of-life communication significantly impacts hospice discussions.
- Favorable physician perceptions of hospice promote its utilization.
- Addressing physician-centric factors can improve hospice access for patients.
Abstract:
Previous research has affirmed the key role of the physician in the decision to use hospice. Yet at least 1/4 of the physicians who have the opportunity to discuss hospice with a terminally ill patient never do so, and those that do so are selective. The present study used a qualitative approach to investigate the factors considered by the physician when deciding to discuss hospice with a patient. Participants were 17 practicing physicians who had referred patients to the one certified hospice in the geographic area of the study. Data were gathered by means of semi-structured interviews, which were audiotaped and transcribed for thematic analysis. The final categorization of data divided themes along two dimensions: a content dimension and a second dimension called incentives and disincentives. It is proposed that the physician's proactive stance toward disclosure of the terminal diagnosis and perception of hospice as an opportunity for death with dignity create a culture within which the work that is necessary to make the other factors favorable toward use of hospice is accomplished.