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Perceived benefits and barriers to hospice care in nursing homes

Susan C. Miller, PhD, Center for Gerontology and Health Care Research and Department of Community Health, Brown University, 2 Stimson Street, Room 207, Providence, RI 02912, (401) 863-9216, Susan_Miller@brown.edu and Ullanda Fyffe, Department of Community Health, Brown University, 2 Stimson Street, 1st floor, Providence, RI 02896.

Specific Purpose: This study's purpose was to examine administrators’ perceptions of hospice care in nursing homes (NHs). Content: Sixty-six Rhode Island NH administrators responded (N=65; 71% response). Methodology: A mail survey solicited ratings on the benefits of hospice in NHs. Rating items related to potential benefits to residents/families, NH staff and to NH organizations; a 4-point linkert scale was used. Descriptive statistics and logistic regression were used. Results: Eight-two percent of the NHs had a hospice contract in place. Higher proportions of “beneficial” ratings were observed in NHs with, versus without, hospice contracts. Hospice was rated as beneficial to the resident/family by 98% of the contracting NHs and 83% of the non-contracting NHs, to NH staff by 100% versus 73%, and to the NH organization by 96% versus 73%. Lower proportions of administrators rated hospice as being beneficial to the financial status or survey outcomes of NHs. In multivariate analyses, a “beneficial” rating in survey outcomes was significantly associated with the presence of a contract. Twenty-six percent (of 38 responding to an open-ended question) noted the reimbursement system doesn’t promote hospice utilization, and several cited as an example the lack of Medicare hospice access to Medicare SNF residents. Importance: Based on findings, one potential approach to increasing the proportion of NHs contracting with hospice is the sharing of hospice “success stories,” especially as they relate to NH survey experiences. Also, reexamination of reimbursement and eligibility policy appears needed to ensure the benefits of hospice care in NHs are more widespread.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

Keywords: End-of-Life Care, Nursing Homes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Innovations for Older Adults' Health and Well-being

The 132nd Annual Meeting (November 6-10, 2004) of APHA