@article{8cb8407828924f2faccc9bf40ab310af,
title = "Differences in Caregiver Reports of the Quality of Hospice Care Across Settings",
abstract = "OBJECTIVES: To examine variation in reported experiences with hospice care by setting. DESIGN: Consumer Assessment of Healthcare Providers and Systems Hospice (CAHPS{\textregistered}) Survey data from 2016 were analyzed. Multivariate linear regression analysis was used to examine differences in measure scores by setting of care (home, nursing home [NH], hospital, freestanding hospice inpatient unit [IPU], and assisted living facility [ALF]). SETTING: A total of 2636 US hospices. PARTICIPANTS: A total of 311 635 primary caregivers of patients who died in hospice. MEASUREMENTS: Outcomes were seven hospice quality measures, including five composite measures that assess aspects of hospice care important to patients and families, including hospice team communication, timeliness of care, treating family member with respect, symptom management, and emotional and spiritual support, and two global measures of the overall rating of the hospice and willingness to recommend it to friends and family. Analyses were adjusted for mode of survey administration and differences in case-mix between hospices. RESULTS: Caregivers of decedents who received hospice care in a NH reported significantly worse experiences than caregivers of those in the home for all measures. ALF scores were also significantly lower than home for all measures, except providing emotional and spiritual support. Differences in NH and ALF settings compared to home were particularly large for hospice team communication (ranging from −11 to −12 on a 0-100 scale) and getting help for symptoms (ranging from −7 to −10). Consistently across all care settings, hospice team communication, treating family member with respect, and providing emotional and spiritual support were most strongly associated with overall rating of care. CONCLUSIONS: Important opportunities exist to improve quality of hospice care in NHs and ALFs. Quality improvement and regulatory interventions targeting the NH and ALF settings are needed to ensure that all hospice decedents and their family receive high-quality, patient- and family-centered hospice care. J Am Geriatr Soc 68:1218–1225, 2020.",
keywords = "care setting, experience of care, hospice, nursing home, survey",
author = "Quigley, {Denise D.} and Layla Parast and Ann Haas and Elliott, {Marc N.} and Teno, {Joan M.} and {Anhang Price}, Rebecca",
note = "Funding Information: The data collection and analysis on which this publication is based was sponsored under contract numbers HHSM‐500‐2016‐00022G and 75FCMC19F0026, entitled, “National Implementation of the consumer assessment of healthcare providers and systems (CAHPS) Hospice Survey,” funded by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. Funding Information: The data collection and analysis on which this publication is based was sponsored under contract numbers HHSM-500-2016-00022G and 75FCMC19F0026, entitled, ?National Implementation of the consumer assessment of healthcare providers and systems (CAHPS) Hospice Survey,? funded by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. The authors have no conflicts of interest. Quigley contributed substantially to the conception and design of this study, the interpretation of data, and drafting and revising the article, and has approved the final submitted version. Parast contributed substantially to the conception and design of this study, the analysis and interpretation of data, and drafting and revising the article, and has approved the final submitted version. Haas contributed to the analysis and interpretation of data and revising the article and has approved the final submitted version. Elliott contributed substantially to the conception and design of this study, the analysis and interpretation of data, and revising the article, and has approved the final submitted version. Teno contributed substantially to the conception and design of this study, the interpretation of data, and revising the article, and has approved the final submitted version. Anhang Price contributed substantially to the conception and design of this study, the acquisition and interpretation of data, and revising the article, and has approved the final submitted version. The sponsor, Centers for Medicare and Medicaid Services, provided input and approved the proposed design of the study, methods for data collection and analysis, and the submitted version of the article. The content of this publication neither necessarily reflect the views or policies of the Department of Health and Human Services nor does the mention of trade names, commercial products, or organizations imply endorsement by the US government. The authors assume full responsibility for the accuracy and completeness of the ideas presented. Publisher Copyright: {\textcopyright} 2020 The American Geriatrics Society",
year = "2020",
month = jun,
day = "1",
doi = "10.1111/jgs.16361",
language = "English (US)",
volume = "68",
pages = "1218--1225",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "6",
}