Patients receiving care from for-profit hospices received a narrower range of hospice services than patients who received care from not-for-profit hospices, Yale researchers report.
"Our results suggest that more understanding of for-profit motives on patient care is warranted," said senior author Elizabeth H. Bradley, associate professor in the Department of Epidemiology and Public Healthat Yale School of Medicine. "This result is not a consequence of differences in patient or hospice characteristics such as diagnosis, disability, demographics, or hospice location."
Bradley said hospice is increasingly being provided by for-profit organizations and she and her team examined whether profit motive affected the delivery of health care services. The authors focused on hospice care, which is care for terminally ill patients and their families and includes services such as palliative care, bereavement counseling, and respite care. They analyzed data on over 2,000 patients receiving care from over 400 hospices nationwide in an effort to determine if for-profit and nonprofit hospices provided a similar pattern of care to their terminally ill patients.
"The shift from a nonprofit, grass roots movement to an industry with a sizable for-profit presence is dramatic," said Bradley. "We questioned whether this could have changed end-of-life care and found that it does."
According to the study's lead author, Melissa D.A. Carlson, "As the presence of for-profit firms in health care delivery continues to grow, it is imperative for the public health community to better understand the impact of profit motive on patient care, particularly for vulnerable patients like the elderly and the dying."
William T. Gallo, associate research scientist at Yale, was also an author on the study.
This research was conducted with support from the Nathan Cummings Foundation, the Patrick and Catherine Weldon Donaghue Medical Research Foundation, and the Claude D. Pepper Older Americans Independence Center at Yale.
Citation: Medical Care: Vol. 42(5) May 2004 pp 432-438.
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