Affiliation:
1. University of Central Florida, Orlando, Florida, United States
Abstract
Abstract
The U.S. hospice industry has expanded over the last decade. Similar to nursing homes, research guided by the Donabedian framework has documented quality differences in hospice based on agency characteristics, including profit status and rural status. Yet, compared to nursing homes, quality oversight and transparency in hospice remain limited. When families report substandard care, a complaint survey is launched to investigate allegations. Using publicly available regulatory oversight data (e.g., CMS QCOR, Medicare PACPUF, CAHPS HIS, Hospice Compare), and guided by the Donabedian framework, this study describes hospice agency structure and process characteristics associated with care complaint deficiencies (outcome). Of the 4,415 hospice facilities examined, 453 (or 10.3%) have had complaint survey deficiency citations between January 2018 and December 2020. Chi-square and ANOVA tests were conducted to compare facility characteristics (e.g., ownership status, percentage of Medicare beneficiaries in rural zips), nursing and social work involvement, and CAHPS scores between hospices with and without complaint survey deficiencies. Results indicated that the average proportion of beneficiaries with a rural zip for Medicare correspondence was significantly lower in hospices with deficiencies (p<.001). Finding also suggested that weekly total nursing and social work minutes were significantly higher in hospices with deficiencies. Additionally, family ratings of hospice team communication, symptom management, and overall satisfaction were higher in facilities without complaint survey deficiencies. Future research and practice implications will be discussed.
Publisher
Oxford University Press (OUP)
Subject
Life-span and Life-course Studies,Health Professions (miscellaneous),Health (social science)
Cited by
1 articles.
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