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For-Profit Ownership and End-of-Life Care

营利性所有权和临终关怀

基本信息

批准号：
7659548
负责人：
Elizabeth Howe Bradley
金额：
$ 44.8万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-08-15 至 2010-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7659548
关键词：
Accident and Emergency department Acute Address Advance Care Planning Affect Agreement Anxiety Area Bereavement Capital Caregivers Caring Cessation of life Chemotherapy-Oncologic Procedure Clinical Communities Community Outreach Comorbidity Complex County Data Data Collection Data Set Databases Demographic Factors Drops Emotional Enrollment Ensure Evaluation Family Family Caregiver Governing Board Government Growth Health Care Sector Health Services Healthcare Home Nursing Care Home environment Hospice Care Hospitals Industry Information Technology Institute of Medicine (U.S.)Intensive Care Units Knowledge Language Length Length of Stay Life Linear Models Link Literature Malignant Neoplasms Managed Care Measures Medical Surveillance Medicare Medicare claim Ownership Pain Pain management Palliative Care Patient Care Patient Transfer Patients Pharmaceutical Preparations Policies Private Sector Process Provider Published Comment Quality Indicator Quality of Care Research Resources Rewards Services Site Solutions Surveys Symptoms Telephone Telephone Interviews Time Visit Work base cancer care cost depression end of life end of life care experience financial incentive health care delivery health care service organization hospice environment improved interest neoplasm registry novel policy implication satisfaction symptom management volunteer

项目摘要

DESCRIPTION (provided by applicant): Hospice is an increasingly important aspect of care for patients with cancer and their families; currently, more than half of all patients dying from cancer use hospice. In the last decade, the hospice industry has experienced dramatic growth, in for-profit ownership. The number of for-profit hospices grew 300% while the number of nonprofit hospices grew only 43%. Despite this expansion, we know little about how for-profit ownership affects end-of-life care for patients with cancer and their families. To address this gap in knowledge, we will produce critical evidence about the impact of for-profit hospice ownership on cancer care. Our specific aims are: 1) to determine the association between hospice ownership type and claims-based quality indicators for patients dying from cancer, adjusted for patient and county-level features, and 2) to determine the association between hospice ownership type and additional quality indicators for patients dying from cancer that cannot be assessed with claims data and examine how these associations are modified by other organization-level features. For the first of these specific aims, we have created a unique dataset that has linked the Surveillance, Epidemiology, and End Results-Medicare database with the Medicare Provider of Services data and the Area Resource File and includes detailed clinical and utilization data for 88,293 patients with cancer. For the second specific aim, we will develop, pretest, and field a survey of 500 hospice organizations to evaluate organization-based quality indicators that have been recommended by RAND, the National Quality Forum, and the Institute of Medicine. The phenomenon of increasing for-profit ownership of hospice is dramatic, current, and has potentially far-reaching implications for patients with cancer and their families. At a time when government and employers are looking for private sector solutions to health care problems, it makes sense to ask what impact for-profit hospice ownership has on end-of-life care and to identify opportunities for improving cancer care. Relevance in lay language: We will generate knowledge about the influence of for-profit hospice ownership on the experiences of patients with cancer and their families.

描述(由申请人提供)：临终关怀是癌症患者及其家人护理的一个日益重要的方面；目前，超过一半的癌症死亡患者使用临终关怀。在过去的十年里，临终关怀行业在营利性所有权方面经历了戏剧性的增长。营利性临终关怀机构的数量增长了300%，而非营利性临终关怀机构的数量仅增长了43%。尽管这种扩张，我们对营利性所有权如何影响癌症患者及其家人的临终关怀知之甚少。为了解决这一知识差距，我们将提供关于营利性临终关怀所有权对癌症护理影响的关键证据。我们的具体目标是：1)确定临终关怀所有权类型与癌症死亡患者的基于索赔的质量指标之间的关联，并根据患者和县级特征进行调整；2)确定临终关怀所有权类型与无法使用索赔数据评估的癌症死亡患者的额外质量指标之间的关联，并检查这些关联如何被其他组织级别的特征修改。对于第一个具体目标，我们创建了一个独特的数据集，它将监测、流行病学和最终结果-联邦医疗保险数据库与联邦医疗保险服务提供者数据和区域资源文件联系起来，并包括88,293名癌症患者的详细临床和利用数据。对于第二个具体目标，我们将制定、预测和现场调查500个临终关怀组织，以评估兰德、国家质量论坛和医学研究所推荐的基于组织的质量指标。越来越多的营利性拥有临终关怀的现象是戏剧性的、当前的，并对癌症患者及其家人具有潜在的深远影响。在政府和雇主为医疗保健问题寻找私营部门解决方案的时候，询问营利性临终关怀所有权对临终关怀有什么影响，并确定改善癌症护理的机会是有意义的。外行语言的相关性：我们将产生关于营利性临终关怀所有权对癌症患者及其家人经历的影响的知识。

项目成果

期刊论文数量（12）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Massage, Music, and Art Therapy in Hospice: Results of a National Survey.

临终关怀中心的按摩、音乐和艺术治疗：全国调查结果。

DOI：
10.1016/j.jpainsymman.2014.11.295
发表时间：
2015
期刊：
Journal of pain and symptom management
影响因子：
4.7
作者：
Dain,AleksandraS;Bradley,ElizabethH;Hurzeler,Rosemary;Aldridge,MelissaD
通讯作者：
Aldridge,MelissaD

Benefits and challenges in use of a standardized symptom assessment instrument in hospice.

在临终关怀中使用标准化症状评估工具的好处和挑战。

DOI：
10.1089/jpm.2009.0245
发表时间：
2010
期刊：
Journal of palliative medicine
影响因子：
2.8
作者：
Schulman-Green,Dena;Cherlin,EmilyJ;McCorkle,Ruth;Carlson,MelissaDA;Pace,KarenBeckman;Neigh,Janet;Hennessy,Meliessa;Johnson-Hurzeler,R;Bradley,ElizabethH
通讯作者：
Bradley,ElizabethH

Hospice Services for Complicated Grief and Depression: Results from a National Survey.

DOI：
10.1111/jgs.13656
发表时间：
2015-10
期刊：
Journal of the American Geriatrics Society
影响因子：
6.3
作者：
Ghesquiere AR;Aldridge MD;Johnson-Hürzeler R;Kaplan D;Bruce ML;Bradley E
通讯作者：
Bradley E

Associations of Hospice Disenrollment and Hospitalization With Continuous Home Care Provision.

DOI：
10.1097/mlr.0000000000000776
发表时间：
2017-09
期刊：
Medical care
影响因子：
3
作者：
Wang SY;Dang W;Aldridge MD;Canavan M;Cherlin E;Bradley E
通讯作者：
Bradley E

Experiences of participants in a collaborative to develop performance measures for hospice care.

参与者合作制定临终关怀绩效衡量标准的经验。

DOI：
10.1016/s1553-7250(11)37005-5
发表时间：
2011
期刊：
Joint Commission journal on quality and patient safety
影响因子：
2.3
作者：
Schulman-Green,Dena;Cherlin,Emily;Pace,KarenBeckman;Hennessy,Meliessa;Crocker,PatriciaA;Bradley,ElizabethH
通讯作者：
Bradley,ElizabethH