Hospice in the United States. Multiple models and varied programs.

Area of Science:

• Medical Sociology
• History of Medicine
• Health Services Research

Background:

• The dominance of cure-oriented medical technology created psychosocial challenges in patient care.
• A need emerged for alternative care models addressing the holistic needs of patients.

Purpose of the Study:

• To review the evolution of hospice care in the United States from the mid-1960s to the early 1980s.
• To describe the psychosocial context and the emergence of hospice as a response.
• To outline the development of organizational models, reimbursement, and standards.

Main Methods:

• Historical review of hospice care development.
• Analysis of organizational structures and funding mechanisms.
• Examination of the establishment of care standards and accreditation.

Main Results:

• Identified 6 major organizational models and variations in hospice care.
• Described reimbursement sources and methods prior to Medicare Hospice Benefit.
• Detailed the emergence of care standards and the JCAH accreditation process.

Conclusions:

• Hospice care emerged as a significant response to the limitations of a cure-focused medical system.
• The period saw the formalization of hospice through defined models, reimbursement, and accreditation.
• Standardization and accreditation were crucial for the integration and recognition of hospice services.