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JOURNAL CLUB: 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

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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

Published in: Health & Medicine

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  • http://www.flickr.com/photos/21560098@N06/3796822070/
  • Odds Ratio for Dementia patient 2.32 (1.44-3.72
  • 15 sec
  • Transcript

    • 1. 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)
    • 2. Blog post on this article at:
      Slidedeck hosted at:
    • 3. This slidedeckhas links.
      Please click on things!
    • 4. 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?
    • 5. 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
    • 6. 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
    • 7. Race/Ethnicity (Table 1)
    • 8. Diagnosis (Table 2)
    • 9. Length of Stay Categories (Table 3)
    • 10.
    • 11. Weak Points of Study
      Included only discharged patients
      Lacked agency specific data
      Lacked costs and revenues
      No correlation between data and quality of care
    • 12. Conclusions
      Not sure this adds more than the MedPAC 2008 report
      Media coverage full of hyperbole
    • 13.
    • 14.
    • 15. 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?
    • 16. If you liked this slide deck…
      Share your slidedecks
      Comment
      Tweet, Share
      Feel free to download, remix, improve upon
      Please give attribution to:
      Christian Sinclair, MD, FAAHPM
    • 17. 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.
    • 18. Christian Sinclair, MD, FAAHPM
      Let’s get connected!
      Skype:
      ctsinclair