Variation in Hospice Experiences by Care Setting for Patients With Dementia.
Survey
nursing home
quality of care
Journal
Journal of the American Medical Directors Association
ISSN: 1538-9375
Titre abrégé: J Am Med Dir Assoc
Pays: United States
ID NLM: 100893243
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
23
12
2021
revised:
09
03
2022
accepted:
14
03
2022
pubmed:
18
4
2022
medline:
14
9
2022
entrez:
17
4
2022
Statut:
ppublish
Résumé
Use of hospice care among patients with dementia has been steadily increasing. Our objectives were to characterize quality of hospice care experiences among decedents who had a primary diagnosis of dementia and their caregivers and investigate differences across settings of hospice care. We analyzed Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey data from caregiver respondents whose family members received hospice care. Data from 96,845 caregiver respondents whose family members had a primary diagnosis of dementia and died in 2017 or 2018 while receiving hospice care in 2829 hospices. We calculated quality measure scores overall and stratified by setting, adjusting for mode of survey administration and differences in case mix, and examined variability in hospice-level scores among decedents with dementia. Mean quality measure scores ranged from 69.0 (Getting Hospice Care Training) to 90.9 (Getting Emotional Support). Measure scores varied significantly across settings, with caregivers of decedents who received care in a nursing home (NH), acute care hospital (ACH), or assisted living facility (ALF) consistently reporting poorer quality of care. Hospice-level scores varied substantially, with a wide range between the 10th and 90th percentiles of hospice performance (eg, 25 points). There are important opportunities to improve hospice care for patients with dementia and their caregivers, particularly with respect to caregiver training, symptom management, and across all dimensions within the NH, ACH, and ALF settings. Variability in care experiences across hospices, as well as long lengths of stay for those with dementia, highlight the importance of informed and timely hospice referral.
Identifiants
pubmed: 35430207
pii: S1525-8610(22)00241-9
doi: 10.1016/j.jamda.2022.03.010
pmc: PMC10372780
mid: NIHMS1907926
pii:
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1480-1485.e6Subventions
Organisme : NICHD NIH HHS
ID : P2C HD042849
Pays : United States
Informations de copyright
Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Références
J Am Geriatr Soc. 2011 Aug;59(8):1531-6
pubmed: 21797834
J Pain Symptom Manage. 2013 Apr;45(4):735-45
pubmed: 23102560
J Pain Symptom Manage. 2007 Jul;34(1):7-16
pubmed: 17509813
Health Aff (Millwood). 1983 Summer;2(2):80-90
pubmed: 6352442
JAMA. 1999 Jan 13;281(2):163-8
pubmed: 9917120
Am J Alzheimers Dis Other Demen. 2002 Sep-Oct;17(5):299-302
pubmed: 12392267
Health Aff (Millwood). 2017 Jul 1;36(7):1175-1183
pubmed: 28679803
J Palliat Med. 2011 Mar;14(3):287-92
pubmed: 21265631
J Clin Oncol. 2014 Nov 1;32(31):3534-9
pubmed: 25287831
J Am Geriatr Soc. 2020 Jun;68(6):1218-1225
pubmed: 32039474
J Pain Symptom Manage. 2018 Oct;56(4):519-529.e1
pubmed: 30048765
Int J Older People Nurs. 2014 Jun;9(2):106-17
pubmed: 24813859
J Am Med Dir Assoc. 2018 Jul;19(7):633-638
pubmed: 29153752
J Am Geriatr Soc. 2010 Dec;58(12):2284-91
pubmed: 21143437
J Pain Symptom Manage. 2004 Oct;28(4):316-28
pubmed: 15471649
Health Serv Res. 1985 Oct;20(4):407-22
pubmed: 4055382
J Pain Symptom Manage. 2018 Feb;55(2):427-432.e1
pubmed: 29024708
Gerontologist. 2000 Oct;40(5):574-81
pubmed: 11037936
J Am Geriatr Soc. 2018 Mar;66(3):546-552
pubmed: 29360140
Health Serv Res. 2009 Apr;44(2 Pt 1):501-18
pubmed: 19317857
J Palliat Med. 2018 Jul;21(7):924-932
pubmed: 29649404
Health Aff (Millwood). 2017 Jul 1;36(7):1283-1290
pubmed: 28679816
J Gen Intern Med. 2021 Apr;36(4):961-969
pubmed: 33469741
R I Med J (2013). 2014 Apr 01;98(4):26-9
pubmed: 25830170
Pediatrics. 2003 Mar;111(3):495-502
pubmed: 12612227
JAMA Intern Med. 2016 Aug 1;176(8):1095-102
pubmed: 27367547
J Health Polit Policy Law. 2016 Aug;41(4):697-716
pubmed: 27127256
Med Care. 2020 Apr;58(4):329-335
pubmed: 31985587
J Am Geriatr Soc. 2013 Jul;61(7):1060-5
pubmed: 23710597
J Pain Symptom Manage. 2003 Jan;25(1):48-52
pubmed: 12565188
Am J Hosp Palliat Care. 2005 Sep-Oct;22(5):344-8
pubmed: 16225356
J Am Geriatr Soc. 1997 Sep;45(9):1054-9
pubmed: 9288011
Am J Hosp Palliat Care. 1997 Jul-Aug;14(4):190-5
pubmed: 9295429
J Public Health Med. 1993 Mar;15(1):3-8
pubmed: 7682424
J Pain Symptom Manage. 2009 Sep;38(3):440-51
pubmed: 19735904