Poster #19

Category: Pre-Doctoral Social Science/Clinical/Behavioral

DIFFERENCES IN SERVICES PROVIDED TO HOSPICE PATIENTS IN HOME HEALTH AGENCIES AND INDEPENDENT HOSPICE AGENCIES

Shayna E. Rich, Ann L. Gruber-Baldini

Department of Epidemiology and Preventive Medicine,
University of Maryland School of Medicine

Purpose and significance:  Overlapping patient populations and favorable regulations have led many home health agencies to become Medicare and/or Medicaid certified as hospice agencies (dual-certified), but home health and hospice programs differ in focus and scope.  The purpose of this tudy is to compare the services offfered by dual-certified agencies to those offered by agencies only certified as hospices (hospice-only).

Research design and methods:  Data were taken from the 2000 National Home and Hospice Care Survey.  Data were collected from a cross-section of home health and hospice agencies providing services at the time of the survey.  Smapling was stratified using agency type, region, and rural/urban status.  Data were collected through personal interviews with administrators and staff.  The frequency of services and service providers provided by dual-certified and hospice-only agencies were compared.  Logistic regression modeling was used to gauge the importance of certification status.

Results:  Analyses are in progress.  Preliminary results indicated that hospice-only agencies were significantly more lifely than dual-certified agencies to provide many types of services including: physician services (87.2% vs. 52.0%, respectively), medications (91.0% vs. 53.7%), bereavement care (93.5% vs. 79.8%), volunteers (96.1% vs. 77.4%) and spiritual care (95.1% vs. 77.8%).  Hospice-only agencies were significantly more likely to have a large population of current hospice patients (53.6% vs. 29.8% for >=30 patients), a possible confounding variable for services provided.

Conclusions:  Dual-certified agencies may provide fewer services to their hospice patients than hospice-only agencies, including many services considered cornerstones of hospice treatment.  Patients, particularly those with extensive service needs, may be better served by enrolling in independent hospice agencies.