(HealthDay News) — Caregivers of patients receiving hospice care report worse care experiences at for-profit hospices, according to a study published online Feb. 27 in JAMA Internal Medicine.
Rebecca Anhang Price, PhD, from the RAND Corporation in Arlington, VA, and colleagues examined whether differences in profit status are associated with family caregivers’ reports of hospice care experiences using data from the Consumer Assessment of Healthcare Providers and Systems Hospice Survey for 653,208 caregiver respondents. A total of 906 not-for-profit hospices and 1,761 for-profit hospices were included, which had a mean of 25.7 and 13.8 years in operation, respectively.
The researchers found that for all measures, family caregivers reported worse care experiences at for-profit than not-for-profit hospices. After adjustment for hospice characteristics, significant differences in average hospice performance by profit status remained. For-profit hospice performance varied, with 31.1 and 21.9% of for-profit hospices scoring 3 or more points below and 3 or more points above the national average of performance, respectively. In contrast, among not-for-profit hospices, 12.5 and 33.7% scored 3 or more points below and 3 or more points above the average, respectively.
“In the hospice context, poor quality care has been associated with complicated family grief and poorer bereavement adjustment, so this quality gap, combined with the growing dominance of for-profit hospices, is of particular concern,” the authors write.