{"title":"Quality of Nonprofit Hospice Affiliated With Integrated Healthcare Systems.","authors":"Gulmeena Khan, Emmanuelle Belanger, Joan Teno","doi":"10.1016/j.jpainsymman.2024.12.019","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Research shows hospice primary caregivers report better quality of care at Nonprofit (NP) than For-Profit (FP) hospices, but there is variation in quality across NP hospices.</p><p><strong>Objective: </strong>Examine bereaved caregiver reports of the quality as a factor of whether NP hospices are part of an integrated healthcare system that included an acute care hospital.</p><p><strong>Methods: </strong>Cross-sectional study of NP Hospices used star ratings and adjusted hospice composite quality scores May 2023 publicly data reported on the Care Compare website. Using organizational website information, we compared hospices part of an integrated healthcare system with at least one acute care hospital to hospices without that affiliation. Primary outcomes were overall hospice adjusted CAHPs score and star ratings.</p><p><strong>Results: </strong>Nearly one-half (44.5%) of 645 NP hospices were part of integrated healthcare systems. Overall hospice CAHPs scores did not differ by organizational affiliation, mean score 82 [95% CI 82.8-83.6] for hospice part of integrated system vs 83.3 [95% CI 82.9-83.7] those without that affiliation), nor did mean star ratings (3.7 [ 95% CI 3.6-3.8] vs. 3.8[ 95% CI 3.7-3.8]) and CAHPs scores 3 points or more below the national average (29.5%[95% CI 24.3-35.1] vs 30.8%[ 95% CI 26.0-35.9]). State fixed-effects models showed a trend towards lower quality among hospice in integrated systems but did not reach conventional statistical significance.</p><p><strong>Conclusion: </strong>CAHPs hospice scores did not differ if a hospice was part of integrated healthcare system or not. Further research is needed on variation in quality in NP hospices.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpainsymman.2024.12.019","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Context: Research shows hospice primary caregivers report better quality of care at Nonprofit (NP) than For-Profit (FP) hospices, but there is variation in quality across NP hospices.
Objective: Examine bereaved caregiver reports of the quality as a factor of whether NP hospices are part of an integrated healthcare system that included an acute care hospital.
Methods: Cross-sectional study of NP Hospices used star ratings and adjusted hospice composite quality scores May 2023 publicly data reported on the Care Compare website. Using organizational website information, we compared hospices part of an integrated healthcare system with at least one acute care hospital to hospices without that affiliation. Primary outcomes were overall hospice adjusted CAHPs score and star ratings.
Results: Nearly one-half (44.5%) of 645 NP hospices were part of integrated healthcare systems. Overall hospice CAHPs scores did not differ by organizational affiliation, mean score 82 [95% CI 82.8-83.6] for hospice part of integrated system vs 83.3 [95% CI 82.9-83.7] those without that affiliation), nor did mean star ratings (3.7 [ 95% CI 3.6-3.8] vs. 3.8[ 95% CI 3.7-3.8]) and CAHPs scores 3 points or more below the national average (29.5%[95% CI 24.3-35.1] vs 30.8%[ 95% CI 26.0-35.9]). State fixed-effects models showed a trend towards lower quality among hospice in integrated systems but did not reach conventional statistical significance.
Conclusion: CAHPs hospice scores did not differ if a hospice was part of integrated healthcare system or not. Further research is needed on variation in quality in NP hospices.
背景：研究显示，非营利性（NP）安宁疗护的主要照护者比营利性（FP）安宁疗护的照护品质更好，但不同NP安宁疗护的照护品质有差异。目的：检验丧亲照护者报告的质量，作为NP安宁疗护是否是包括急症护理医院在内的综合医疗保健系统的一部分的一个因素。方法：对NP临终关怀医院进行横断面研究，采用星级评定和调整后的临终关怀综合质量评分。利用组织网站信息，我们比较了至少有一家急症护理医院的综合医疗保健系统的安宁疗护院与没有这种联系的安宁疗护院。主要结果是总体安宁疗护调整后的CAHPs评分和星级评分。结果：645家NP临终关怀医院中近一半（44.5%）是综合医疗保健系统的一部分。总体而言，安宁疗护CAHPs评分并无组织隶属关系的差异，综合系统安宁疗护部分的平均评分为82分[95% CI 82.8 - 83.6]，而无组织隶属关系的平均评分为83.3分[95% CI 82.9 - 83.7]，平均星级评分也无差异（3.7分[95% CI 3.6 - 3.8]对3.8分[95% CI 3.7 - 3.8]）， CAHPs评分低于全国平均水平3分或以上（29.5%[95% CI 24.3 - 35.1]对30.8%[95% CI 26.0 - 35.9]）。国家固定效应模型显示综合系统的安宁疗护品质有降低的趋势，但未达到传统的统计显著性。结论：CAHPs安宁疗护评分不因安宁疗护是否是综合医疗系统的一部分而有差异。NP安宁疗护的品质差异有待进一步研究。
期刊介绍：
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
