Increased Length of Stay in For-Profit Hospices

For-profit hospices have more patients with diagnoses requiring less resource-intensive care

TUESDAY, Feb. 1 (HealthDay News) -- Hospice agencies that operate for profit have a higher percentage of patients with diagnoses associated with lower-skilled needs, and longer length of stay compared to nonprofit hospice agencies, according to a study published in the Feb. 2 issue of the Journal of the American Medical Association.

Melissa W. Wachterman, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues reviewed a sample of 4,705 patients discharged from hospices in the 2007 National Home and Hospice Care Survey. Diagnoses, length of stay, and number of visits per day by hospice workers were measured.

The investigators found that for-profit hospices had a lower proportion of patients with cancer, and a higher proportion of patients with dementia and other noncancer diagnoses compared with nonprofit hospices. Patients in for-profit hospices had a significantly longer length of stay, compared with nonprofit hospices, and for-profit hospices were more likely to have patients who stayed longer than 365 days, and less likely to have patients with stays shorter than seven days. Patients with dementia or other diagnoses had significantly fewer visits from nurses and social workers per day compared to patients with cancer.

"Given that approximately one million Medicare beneficiaries use hospice each year and that the for-profit hospice industry continues to expand rapidly, future research is needed to understand more fully the association of profit status with quality of care and patient and caregiver experiences at the end of life," the authors write.

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