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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.
