Document Detail


Is a home-care network necessary to access the Medicare hospice benefit?
MedLine Citation:
PMID:  19591625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test whether the presence of an informal or formal care network in the home leads to different hospice utilization patterns near death. To examine how the informal care relationship affects hospice use patterns. DATA SOURCES: Medicare Current Beneficiary Survey (MCBS), 1997-2001. STUDY DESIGN: Using logistic regression and ordinary least squares, we examine the association between a person's in-home network of care and the use of Medicare hospice services in the last year of life. We also examine whether the care-dyad relationship is associated with different hospice use patterns. DATA EXTRACTION: All individuals in the MCBS who lived at home at the time of the interview and who died between 1998 and 2001, 1404 persons. PRINCIPAL FINDINGS: People receiving formal home care had a much higher chance of enrolling in hospice prior to death. Informal care did not influence the likelihood of hospice but was associated with longer use among hospice users. Daughter caregivers increased the likelihood and duration of hospice use whereas sons significantly decreased the likelihood. CONCLUSIONS: Because formal care is associated with increased use of hospice, future work should examine whether patients without an in-home network faced access barriers. Caregiver relationships had large effects on length of hospice stays, yet we do not know whether changes moved a patient closer to or further away from their optimum use of the benefit.
Authors:
Courtney Harold Van Houtven; Donald H Taylor; Karen Steinhauser; James A Tulsky
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of palliative medicine     Volume:  12     ISSN:  1557-7740     ISO Abbreviation:  J Palliat Med     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9808462     Medline TA:  J Palliat Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  687-94     Citation Subset:  IM    
Affiliation:
Center for Health Services Research and Development in Primary Care, VA Medical Center, Durham, North Carolina 27705, USA. courtney.vanhoutven@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Female
Health Care Surveys
Home Care Services / organization & administration*
Hospice Care / utilization*
Humans
Logistic Models
Male
Medicare*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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