Geographic Access to Hospice in the United States

Carlson, Melissa; Bradley, Elizabeth H.; Du, Qingling; Morrison, R. Sean

doi:10.1089/jpm.2010.0209

Cited by 78 publications

(58 citation statements)

References 24 publications

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“…27 Another review focused on GIP care claims highly vulnerable to fraud; one such type was GIP care of seven or more days in a monthly billing period; this edit reported a denial rate of nearly 62%. 28 Armed with these audit results, the CMS has made it clear to hospice providers that care can be billed at the GIP level in the event of imminent death, a direct discharge from a hospital to a hospice, or a caregiver breakdown, but only when the hospice provider can provide the documentation supporting a need for aggressive pain/symptom management. Hospice care billed previously as GIP care is now strictly reimbursed only at the routine care rate or respite care rate—leading to a considerable reduction in payments.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Hospice Patients Utilizing Hospice Inpatient/Residential Facilities

Chung

Burke

2012

Am J Hosp Palliat Care

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Given the increasing popularity of a hospice inpatient/residential facility (HIRF) among hospice patients and their family members, examining who uses HIRFs has been of increasing importance. Using the 2007 National Home and Hospice Care Survey (NHHCS), we found that about 14% of hospice patients received care in a HIRF in 2007. Characteristics of patients associated with HIRF use largely match the industry norm for a general inpatient level of care, and include: having no caregiver, or having an incapable caregiver; having imminent death; and being directly admitted to a hospice after discharge from a hospital. Given a recent stricter enforcement of reimbursement rules, however, we call for close monitoring of any change in the number of HIRF beds—particularly in rural and low-income urban areas.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Hospice Patients Utilizing Hospice Inpatient/Residential Facilities

Chung

Burke

2012

Am J Hosp Palliat Care

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“…More recently, Carlson and colleagues used 2008 Medicare data to estimate the proportion of the U.S. population living within 30 and 60 minutes driving time of a hospice. 13 The researchers showed that 88% of the population lived in a community within 30 minutes and 98% lived in a community within 60 minutes of a hospice. The literature suggests that the recent growth in the hospice industry may have resulted in widespread geographic access to hospice care in the United States.…”

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confidence: 99%

Geographic Access to Hospice Care for Children With Cancer in Tennessee, 2009 to 2011

Lindley

Edwards

2014

Am J Hosp Palliat Care

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The geographic interface between the need for and the supply of pediatric hospice may be critical in whether children with cancer access care. This study sought to describe the geographic distribution of pediatric hospice need and supply and identify areas lacking pediatric hospice care in Tennessee over a 3 year time period. Using ArcGIS, a series of maps were created. There was a consistent need for care among children with cancer across the state. Most urban areas were supplied by pediatric hospices, except the Knoxville area. Areas within the state were identified where the supply of pediatric hospice care declined, while the need for hospice care was unchanging. This study has important regulatory implications for clinicians practicing in Certificate of Need states such as Tennessee.

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“…This may be due not only to an increase in availability and accessibility of hospice but also to its acceptability among African Americans as a result of initiatives to address potential barriers to hospice use. [1][2][3][4][5][6][7][8] The most commonly cited barriers to hospice use for African Americans include preferences for life-sustaining therapies, lack of knowledge about hospice, mistrust of the health care system, and spiritual beliefs. [9][10][11][12][13][14] Experts and national organizations have identified a role for individual hospice providers in addressing some of these barriers.…”

Section: Introductionmentioning

confidence: 99%

What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area?

JohnsonKimberly

PayneRichard

KuchibhatlaMaragatha

2016

Journal of Palliative Medicine

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Background: Experts and national organizations recommend that hospices work to increase service to African Americans, a group historically underrepresented in hospice. Objective: The study objective was to describe strategies among hospices in North and South Carolina to increase service to African Americans and identify hospice characteristics associated with these efforts. Methods: The study was a cross-sectional survey using investigator-developed scales to measure frequency of community education/outreach, directed marketing, efforts to recruit African American staff, cultural sensitivity training, and goals to increase service to African Americans. We used nonparametric Wilcoxon tests to compare mean scale scores by sample characteristics. Results: Of 118 eligible hospices, 79 (67%) completed the survey. Over 80% were at least somewhat concerned about the low proportion of African Americans they served, and 78.5% had set goals to increase service to African Americans. Most were engaged in community education/outreach, with 92.4% reporting outreach to churches, 76.0% to social services organizations, 40.5% to businesses, 35.4% to civic groups, and over half to health care providers; 48.0% reported directed marketing via newspaper and 40.5% via radio. The vast majority reported efforts to recruit African American staff, most often registered nurses (63.75%). Nearly 90% offered cultural sensitivity training to staff. The frequency of strategies to increase service to African Americans did not vary by hospice characteristics, such as profit status, size, or vertical integration, but was greater among hospices that had set goals to increase service to African Americans. Conclusions: Many hospices are engaged in efforts to increase service to African Americans. Future research should determine which strategies are most effective.

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Geographic Access to Hospice in the United States

Cited by 78 publications

References 24 publications

Characteristics of Hospice Patients Utilizing Hospice Inpatient/Residential Facilities

Characteristics of Hospice Patients Utilizing Hospice Inpatient/Residential Facilities

Geographic Access to Hospice Care for Children With Cancer in Tennessee, 2009 to 2011

What are Hospice Providers in the Carolinas Doing to Reach African Americans in Their Service Area?

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