scholarly journals Medical complexity and concurrent hospice care: A national study of Medicaid children from 2011 to 2013

2021 ◽  
Author(s):  
Jessica Keim‐Malpass ◽  
Melanie J. Cozad ◽  
Radion Svynarenko ◽  
Jennifer W. Mack ◽  
Lisa C. Lindley
Keyword(s):  
Hospice Care ◽  
National Study ◽  
Medical Complexity ◽  
Medicaid Children

scholarly journals CAREGIVER BURDEN, BENEFIT, AND PERCEPTIONS OF END-OF-LIFE CARE QUALITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S668-S668
Author(s):  
Elizabeth A Luth ◽  
Teja Pristavec
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Hospice Care ◽  
Quality Care ◽  
Care Quality ◽  
National Study ◽  
Life Care ◽  
Care Needs ◽  
Caregiving Burden ◽  
High Burden

Abstract End-of-life care quality (EOLCQ) gauges our success in providing quality care to dying individuals. EOLQC measures rely on reports from bereaved family members who provide care for dying loved ones, but analyses seldom account for how caregivers’ experiences influence their EOLCQ perceptions. Caregivers frequently experience burden, which is linked to poor health outcomes and may negatively bias EOLCQ reports. Individuals may also perceive caregiving benefits that can offset deleterious burden effects, but potentially encourage overly positive EOLCQ perceptions. This paper links National Study of Caregivers (2011) and National Health and Aging Trends Study (2011-2016) data, using regression analysis and a sample of 380 EOL caregivers to examine how caregiving burden and benefits perceptions shape and moderate EOLCQ reports. Caregiving burden is unrelated to EOLCQ in adjusted models. Benefits are associated with marginally greater odds of being informed about the dying person’s condition and reporting their personal care needs were met. Burden and benefits moderate these two measures. Despite benefits, low burden caregivers report they were informed about the dying person’s condition with 90% probability. Regardless of burden, high benefits caregivers report the same with 90% probability. Low burden and benefits caregivers report met care needs with 90% probability. High burden and benefits caregivers have 90% probability of such reports. Given these reports are used in formal hospice care evaluations by CMS, additional research should explore why caregiving burden and benefit are associated with some EOLCQ measures and why individuals reporting high burden and benefits provide more positive EOLCQ appraisals.

A National Study to Compare Effective Management of Constipation in Children Receiving Concurrent Versus Standard Hospice Care

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Lisa C. Lindley ◽  
Jessica Keim-Malpass ◽  
Melanie J. Cozad ◽  
Jennifer W. Mack ◽  
Radion Svynarenko ◽  
...  
Keyword(s):  
Hospice Care ◽  
National Study ◽  
Effective Management

scholarly journals Medical Complexity, Mortality Among High-Cost Medicare Advantage Enrollees: Palliative, Hospice Implications

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 891-891
Author(s):  
Samuel Amodeo ◽  
Henrik Kowalkowski ◽  
Halley Brantley ◽  
Lauren Bangerter ◽  
David Cook ◽  
...  
Keyword(s):  
End Of Life ◽  
Logistic Model ◽  
Hospice Care ◽  
Care Delivery ◽  
Medicare Advantage ◽  
Multinomial Logistic Model ◽  
Complex Needs ◽  
Medical Complexity ◽  
Short Term Mortality ◽  
Multiple Conditions

Abstract Older adults with high medical spend require tailored interventions and care delivery to meet their complex needs. Palliative is a high-value solution for high-cost patients because it provides relief from the symptoms, pain, and stress associated with multiple conditions. Likewise, other high-cost patients may be closer to end-of-life and therefore benefit from hospice care. For Accountable Care Organizations (ACOs) and hospitals to implement palliative care, these programs must identify and target the high-need patient populations. This study explored patterns of spending and mortality across 4 years (2016-2019) using claims from 1,701,647 patients continuously enrolled in UnitedHealth Group Medicare Advantage (mean age=73.7; S.E.=0.01). Patients with healthcare spend in the top decile were segmented into three subgroups based on health conditions and spend patterns. Analyses identified a subgroup of patients (mean age=76.6; S.E.=0.04), with the highest rate of mortality, and significantly more chronic conditions and frailty, indicating their cost and mortality was driven by medical complexity. Odds ratios from a multinomial logistic model tie blood formulation drugs (OR XX), medicative procedures (OR XX), and nonhospital-based care (OR XX) to members of this subgroup may be connected to short-term mortality. There is a critical need to identify patients who stand to benefit from palliative and end of life care, this is particularly true for high-cost high-need patients. Our study suggests that patterns of medical complexity and morality within high-cost patient subpopulations can be used to identify high-cost patients who would benefit from palliative or hospice care.

scholarly journals Patterns of Health Care Services During Pediatric Concurrent Hospice Care: A National Study

2021 ◽  
pp. 104990912110186
Author(s):  
Lisa C. Lindley ◽  
Radion Svynarenko ◽  
Kim Mooney-Doyle ◽  
Annette Mendola ◽  
Wendy C. Naumann ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Latent Class ◽  
Hospice Care ◽  
Care Service ◽  
Health Care Service ◽  
National Study ◽  
Care Needs ◽  
Demographic Profiles ◽  
Care Services

Background: Children at end of life have unique and complex care needs. Although there is increasing evidence about pediatric concurrent hospice care, the health care services received while in hospice have not received sufficient attention. Objectives: To examine the health care services, unique clusters of health care services, and characteristics of the children in the clusters. Methods: Multiple data sources were used including national Medicaid claims data. Children under 21years in pediatric concurrent hospice care were included. Using Medicaid categories assigned to claims, health care services were distributed across 20 categories. Latent class analysis was used to identify clusters of health care services. Demographic profiles of the clusters were created. Results: The 6,243 children in the study generated approximately 500,0000 non-hospice, health care service claims while enrolled in hospice care. We identified 3 unique classes of health care services use: low (61.1%), moderate (18.1%), and high (20.8%) intensity. The children in the 3 classes exhibited unique demographic profiles. Conclusions: Health care services cluster together in unique fashion with distinct patterns among children in concurrent hospice care. The findings suggest that concurrent hospice care is not a 1-size-fit all solution for children. Concurrent hospice care may be customized and require attention to care coordination to ensure high-quality care.

Dysphagia in Hospice Care: The Roles of Social Work and Speech-Language Pathologists

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Case Studies ◽  
End Of Life Care ◽  
Hospice Care ◽  
Patient Communication ◽  
Life Care ◽  
Speech Language Pathologists ◽  
Four Levels

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.

Ethics in hospice care.

1982 ◽  
Vol 37 (11) ◽  
pp. 1263-1265 ◽  
Author(s):  
Samuel C. Klagsbrun
Keyword(s):  
Hospice Care

National Study Turned Book

1994 ◽  
Vol 39 (6) ◽  
pp. 598-599
Author(s):  
Matthew J. Zagumny
Keyword(s):  
National Study
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