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JOURNAL CLUB: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay
 

JOURNAL CLUB: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay

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Slidedeck for Journal Club reviewing JAMA article from Feb 2, 2011: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay

Slidedeck for Journal Club reviewing JAMA article from Feb 2, 2011: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay

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JOURNAL CLUB: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay JOURNAL CLUB: Association of Hospice Agency Profit Status With Patient Diagnosis, Location of Care, and Length of Stay Presentation Transcript

  • Christian Sinclair, MD, FAAHPM
    University of Kansas Medical Center
    Hospice and Palliative Medicine Fellowship
    Journal Club
    February 3rd, 2011
    Free pdf avail
    Click me - (as of 2/3/11)
  • Blog post on this article at:
    Slidedeck hosted at:
  • This slidedeckhas links.
    Please click on things!
  • Clinical Case Correlation
    Palliative Care Consult at a local hospital
    Hospice referral was appropriate
    Conversation with the case manager about different agencies
    Does profit status affect the care received?
  • Background
    For-profit hospice agencies growing
    Nearly half of all hospice agencies are FP
    1660 FP agencies in 2007
    For-profit hospice agencies have higher profit margins1
    FP profit margin 12 to 16%
    NP profit margin -2.9 to -4.4%
    Medicare (CMS) is gathering data to revise the payment structure for hospice benefit
    Flat per-diem v. U-shaped curve
    Higher costs at beginning and end of care days
    1 -MedPAC Report to Congress 2008, Chapter 8
  • Methods
    2007 National Home and Hospice Care Survey
    1545 agencies randomly selected
    1036 participated
    Interviewed staff and reviewed med records
    4705 patients discharged from hospice
    Due to death or live discharge
  • Race/Ethnicity (Table 1)
  • Diagnosis (Table 2)
  • Length of Stay Categories (Table 3)
  • Weak Points of Study
    Included only discharged patients
    Lacked agency specific data
    Lacked costs and revenues
    No correlation between data and quality of care
  • Conclusions
    Not sure this adds more than the MedPAC 2008 report
    Media coverage full of hyperbole
  • Conclusions for This Study
    Not sure this adds more than the MedPAC 2008 report
    Media coverage full of hyperbole
    Does this pit NP vs FP hospice agencies?
    Is this good for the field?
  • If you liked this slide deck…
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    Please give attribution to:
    Christian Sinclair, MD, FAAHPM
  • DISCLAIMER DISCLAIMER DIS D
    This slidedeck:
    does not constitute professional medical advice
    does not constitute a doctor-patient relationship
    Any medical decisions regarding your health should be
    discussed with your health care providers.
    Use common sense when researching health issues online.
    The goal of sharing these slides is to advance medical education.
    References are included wherever possible.
  • Christian Sinclair, MD, FAAHPM
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