Hospice providers that served higher volumes of assisted living patient days had lower-quality scores, according to a new study.
AL community caregivers are known to report lower quality of hospice care, the authors noted. The study sought to examine hospice providers serving AL residents and explain factors that may contribute to, and explain, differences in quality. Some evidence shows that caregivers give lower hospice ratings for assisted living residents. Studies also show that residents spend more time in hospice, have higher Medicare costs and fewer visits from the hospice provider during their last seven days of life.
Researchers weren’t sure if the lower quality of care was consistent with claim-based quality metrics, or if residents were more likely to receive care from lower-quality hospice providers.
The report was published Wednesday in the Journal of the American Geriatrics Society. In it, investigators detailed the link between hospice providers assisted living patient-day volumes and quality ratings. The ratings were based on the Hospice Item Set (HIS) and Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Surveys.
Hospice volume was total hospice patient days involving assisted living residents. Total patient days were the number of patients served by each hospice, multiplied by the length of the person’s stay in days.
Hospice providers with a higher assisted living volume were seven percentage points more likely to have caregivers that gave them lower scores on pain assessment, treatment for difficulty breathing and emotional support compared to those with lower volumes. Their caregivers also reported lower scores in team communications and training the family to provide care. The high-volume hospice providers were five percentage points less likely to have higher CAHPS scores and seven percentage points less likely to have higher HIS scores compared to lower-volume providers.
Hospices with higher numbers of assisted living clients were more likely to have a lower daily census and be for-profit providers, the data showed.
