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For-Profit Hospices May Prefer Certain Types of Patients: Study
Date:2/1/2011

By Serena Gordon
HealthDay Reporter

TUESDAY, Feb. 1 (HealthDay News) -- End-of-life care facilities run for profit are more likely to have patients who require less-skilled care on the part of the hospice, or patients who need longer times in hospice care, research reveals.

Under the current Medicare reimbursement system -- which pays hospices a flat daily rate, regardless of care needs -- such patients would likely cost less to care for, according to the study.

"We found that for-profit hospices had more patients with non-cancer diagnoses, especially dementia, that were associated with fewer visits per day from hospice nurses and social workers," noted the study's lead author, Dr. Melissa Wachterman, a general medicine research fellow, and a palliative care physician at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston.

"There was a difference in the distribution of diagnoses. Non-cancer diagnoses were more common in for-profit hospices. And, under the current reimbursement system, those patients may be more profitable," she explained.

More reassuring for families, however, is the finding that patients' care needs were met in both for-profit and non-profit hospice programs, Wachterman noted.

Results of the study appear in the Feb. 2 issue of the Journal of the American Medical Association.

Hospice is a type of care provided to people who are dying. The aim of hospice care isn't to prolong life, but to provide comfort care in the last weeks or months of life. Pain control is an important aspect of hospice care, as is counseling for the whole family.

Since 2000, the number of for-profit hospice agencies in the United States has more than doubled. In 2000, there were 725 for-profit hospices, and in 2007 that number had risen to 1,660, according to the study. During that same period, the number of non-profit hospice programs held steady at about 1,200 fac
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