Hospice Composition Based on Diagnosis is Associated with Caregiver-Reported Quality Measures

Area of Science:

• Gerontology
• Palliative Care
• Health Services Research

Background:

• The diversity of terminal diagnoses in hospice care is increasing.
• Understanding hospice quality across different patient diagnoses is crucial.
• Limited data exists comparing hospice diagnoses and caregiver-reported outcomes.

Purpose of the Study:

• To analyze the association between hospice patient terminal diagnoses and quality of care.
• To investigate caregiver-reported outcomes in relation to patient diagnostic composition.

Main Methods:

• Utilized cross-sectional, publicly available data from the Centers for Medicare & Medicaid Services (CMS) from 2015-2019.
• Employed general linear model analyses to identify associations between hospice characteristics and caregiver outcomes.
• Analyzed data from 2810 hospices nationwide.

Main Results:

• Hospices with a higher percentage of dementia patients showed lower caregiver ratings for overall quality, pain management, and training.
• Hospices with more stroke patients also reported lower caregiver satisfaction with overall quality, pain management, training, and emotional support.
• Significant negative associations were found between the proportion of dementia/stroke patients and multiple caregiver-reported quality measures.

Conclusions:

• Hospices serving a larger proportion of dementia and stroke patients reported poorer quality scores from caregivers.
• Findings suggest a need to investigate underlying mechanisms for these disparities.
• Strategies are needed to ensure equitable, high-quality hospice care for all patients, irrespective of diagnosis.