Quality of palliative care at US Hospices: Results of a national survey

Melissa D A Carlson, Colleen Barry, Mark Schlesinger, Ruth McCorkle, R. Sean Morrison, Emily Cherlin, Jeph Herrin, Jennifer Thompson, Martha L. Twaddle, Elizabeth H. Bradley

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background The National Quality Forum (NQF) identified hospice services as a national priority area for health care quality improvement and endorsed a set of preferred practices for quality palliative and hospice care. This study reports the first national data regarding hospices self-reported implementation of the NQF preferred practices and identifies hospice characteristics associated with more comprehensive implementation. METHODS: We conducted a national cross-sectional survey of a random sample of hospices (n=591; response rate, 84%) from September 2008 to November 2009. We evaluated the reported implementation of NQF preferred practices in the care of both patients and families. Results: The range of reported implementation of individual NQF preferred practices among hospices was 45% to 97%. Twenty-one percent of hospices reported having implemented all patient-centered preferred practices, 26% all family-centered preferred practices, and 10% all patient and family-centered preferred practices. In adjusted analyses, large hospices (100 or more patients per day) were significantly more likely than small hospices (<20 patients per day) to report having implemented all patient-centered preferred practices [odds ratio (OR)=2.46; 95% CI, 1.24, 4.90] and all family-centered preferred practices (OR=1.88; 95% CI, 1.02, 3.45). Similarly, chain-affiliated hospices were significantly more likely than free-standing hospices to report having implemented all patient-centered preferred practices (OR=2.45; 95% CI, 1.23, 4.87) and all family-centered preferred practices (OR=1.85; 95% CI, 1.01, 3.41). Conclusions: Hospices reported implementation of individual preferred practices for palliative and hospice care quality was high; however, reported comprehensive implementation of preferred practices was rare and may be difficult to achieve for small, free-standing hospices.

Original languageEnglish (US)
Pages (from-to)803-809
Number of pages7
JournalMedical care
Volume49
Issue number9
DOIs
StatePublished - Sep 2011

Keywords

  • hospice and palliative medicine
  • preferred practices
  • quality

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Carlson, M. D. A., Barry, C., Schlesinger, M., McCorkle, R., Morrison, R. S., Cherlin, E., Herrin, J., Thompson, J., Twaddle, M. L., & Bradley, E. H. (2011). Quality of palliative care at US Hospices: Results of a national survey. Medical care, 49(9), 803-809. https://doi.org/10.1097/MLR.0b013e31822395b2