title: The opportunity for collaborative care provision: the presence of nursing home/hospice collaborations in the U.S. states.
abstract: This study estimated the proportion of U.S. nursing homes (NHs) collaborating with Medicare hospices and identified state-level factors associated with this collaboration. Collaboration was classified as present when at least one of a NH's residents dying in July through December, 2000 received hospice. Seventy-six percent of NHs (n=12,174) had hospice collaborations, with proportions ranging from 37% in Wyoming to 96% in Florida. State-level factors associated with greater collaboration included having a lower proportion of persons 65+ residing in rural areas, lower NH occupancy and larger hospices, and Medicaid NH reimbursement which was not case-mixed and was paid directly to NHs (not to hospices) for hospice-enrolled residents. Considering the high amount of estimated NH/hospice collaboration, care provision by both NHs and hospices appears to be a potentially viable approach for providing comprehensive end-of-life care in the majority of U.S. NHs. Findings suggest the rural composition of a state as well as its policies and healthcare market characteristics either foster or discourage NH/hospice collaboration.
authors.affiliation: Department of Community Health, and Center for Gerontology and Health Care Research, Brown University School of Medicine, Providence, Rhode Island 02912, USA.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Miller
authors.forename: Vincent
authors.initials: V
authors.lastname: Mor
mesh_terms: D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000706:statistics & numerical data; D006738:Hospices / Q000458:organization & administration* / Q000706:statistics & numerical data*; D007373:Interinstitutional Relations; D009735:Nursing Homes / Q000458:organization & administration* / Q000706:statistics & numerical data*; D011640:Public Policy; D013727:Terminal Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology