Comparison of the high-tech service delivery experiences of hospice and non-hospice home health providers.
This study examined the degree to which national samples of hospice and non-hospice home health care agencies (N = 154) present different organizational profiles and grapple with different patient capacity issues when delivering technology-enhanced services to incapacitated elderly. Hospice agencies employ more part-time staff, make more in-home visits, see more high-tech patients, and provide a wider range of high-tech services than non-hospice providers. Factor analysis of index data confirms that hospice staff have more experience (p < .05) addressing the legal/ethical dimensions of care. Specifically, hospices deal with "right to die" issues more often (p < .05), but not with "delegation of authority" and "patient rights" issues. More agencies of both types have policies for handling decisions about life-sustaining treatment than for dealing with patients having questionable decision-making capacity. Needed agency policies for dealing with limited patient decision-making capacity in hospice and non-hospice home care agencies are reviewed.
Graduate School of Social Work & Social Research, Bryn Mawr College, PA 19010-1697, USA.
L W
LW
Kaye
J K
JK
Davitt
D003659:Decision Making, Organizational; D005163:Factor Analysis, Statistical; D019538:Health Care Surveys; D006699:Home Care Services / Q000458:organization & administration*; D006738:Hospices / Q000458:organization & administration*; D006801:Humans; D016134:Organizational Policy; D010344:Patient Advocacy; D013675:Technology, High-Cost; D014481:United States