Early Impacts of COVID-19 on Select Hospices: Operations, Care Delivery, and Service Utilization.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Lisa R Shugarman, Lindsay McMillan, Hayley Mitchell, Komal Shah, Ted Kirby, Richard McManus, Katherine Woods, Shannon L Landefeld
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引用次数: 1

Abstract

Objective: The COVID-19 public health emergency (PHE) has important implications for health care service delivery. Little is understood about how the PHE impacted community-based hospice providers and service delivery to hospice-eligible beneficiaries. The aim of this study was to describe hospice response to the PHE and correlated impacts on beneficiary receipt of hospice support services delivered to hospice-eligible beneficiaries participating in the Centers for Medicare & Medicaid Services (CMS) Medicare Care Choices Model (MCCM), a national model testing the provision of certain hospice-like supportive services with concurrent usual care among seriously ill, community-residing Medicare beneficiaries that have not elected to receive hospice care.

Methods: We employed descriptive analysis using concurrent qualitative and quantitative data sources, consisting of provider surveys, beneficiary-level encounter data submitted by hospices, and Medicare administrative claims describing beneficiary service utilization. The sample included both hospice providers (N = 82) and beneficiaries (N = 2294) voluntarily participating in MCCM.

Results: Nearly all participating MCCM hospices adopted operational changes to address their staff and beneficiaries' safety during the COVID-19 PHE. We report changes to service delivery, including declines in total encounters as well as service modality, and the types of services provided.

Conclusions: While the analyses reported indicate that seriously ill Medicare beneficiaries participating in MCCM were directly impacted by the PHE, we are still unclear whether changes in the service modality and encounters by provider type and the decline in average service counts per beneficiary are driven more by hospices or by beneficiary decisions to minimize exposure. Future research should attempt to disentangle these factors.

COVID-19对选定临终关怀医院的早期影响:运营、护理提供和服务利用。
目的:2019冠状病毒病突发公共卫生事件(PHE)对卫生服务提供具有重要意义。人们对PHE如何影响社区临终关怀提供者和向符合临终关怀条件的受益人提供服务知之甚少。本研究的目的是描述安宁疗护对公共健康服务的反应,以及对参与医疗保险与医疗补助服务中心(CMS)医疗护理选择模型(MCCM)的符合安宁疗护条件的受益人提供安宁疗护支持服务的相关影响,MCCM是一个全国性的模型,用于测试在重症患者中提供某些安宁疗护类支持服务并同时提供常规护理。居住在社区的医疗保险受益人没有选择接受临终关怀。方法:我们采用描述性分析,同时使用定性和定量数据源,包括提供者调查,临终关怀医院提交的受益人水平遭遇数据,以及描述受益人服务使用情况的医疗保险行政索赔。样本包括自愿参与MCCM的安宁疗护提供者(N = 82)和受益人(N = 2294)。结果:几乎所有参与的MCCM临终关怀医院都采取了操作变更,以解决其员工和受益人在COVID-19 PHE期间的安全问题。我们报告了服务提供的变化,包括总接触次数、服务方式和提供的服务类型的下降。结论:虽然分析报告表明参与MCCM的重病医疗保险受益人直接受到PHE的影响,但我们仍然不清楚服务模式的变化和提供者类型的遭遇以及每个受益人平均服务次数的下降更多地是由临终关怀还是受益人决定减少暴露。未来的研究应该试图理清这些因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
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