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(c) 2016 Jon L Gelman, All Rights Reserved.

Saturday, March 15, 2014

Differences in Care at For-Profit Hospices

Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

People who pay attention to hospice care, so often a godsend for the dying and their families, have noticed and wondered about two trends in recent years:

1) What began as a grass-roots movement to improve end-of-life care is becoming a business. In 1990, only 5 percent of hospices were for-profit operations; by last year, they dominated the industry, representing 63 percent of hospices.

2) We’ve also seen that hospice patients are increasingly likely to be “disenrolled” before they die. Once, this was a rare event; the greater problem was that patients waited until the eleventh hour to enroll, subjecting themselves and their families to unnecessary stress and suffering.



Now, about 20 percent of hospice patients are discharged alive, the Medicare Payment Advisory Commission has found. Some may have moved, or changed their minds about treatment, but the National Hospice and Palliative Care Organization said its surveys show that hospices, not patients, initiate a great majority of discharges.

In other words, patients are getting bounced as corporate bottom lines have come to matter more. Are these two developments connected? We’ve had our suspicions — but now we have data.
A study published recently in JAMA Internal Medicine has found that for-profit hospices have significantly higher disenrollment rates than nonprofits, among other disparities.

“We’ve shown that differences by ownership affect patient care, services provided and the...
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People who pay attention to hospice care, so often a godsend for the dying and their families, have noticed and wondered about two trends in recent years: 1) What began as a grass-roots movement to improve end-of-life care ...
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Oddly, participation in hospice, which should relieve symptoms rather than prolong life, is above average in the Philadelphia area. Throughout the nation, though, the average patient waits until the last week or two to join ...
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