title: Barriers to hospice care in Alabama: provider-based perceptions.
abstract: Few studies have evaluated barriers to hospice from a hospice provider perspective. We assessed such views via a postal survey to all licensed hospices in Alabama (N = 193)-response = 55.4%. Most providers considered physicians and health care professionals to be somewhat knowledgeable of hospice, but also indicated a lack of knowledge constituted the barrier with the most impact in their communities. Respondents also cited physician difficulties with discussing end of life with patients and prognosticating death within 6 months as leading barriers. Providers also described Medicare reimbursement cap issues that have resulted in barriers to hospice. Our findings were similar to previous investigations assessing provider perceptions. Future studies should explore how reimbursement cap issues affect the receipt and delivery of hospice care.
authors.affiliation: Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. todd.jenkins@cchmc.org
authors.forename: Todd M
authors.initials: TM
authors.lastname: Jenkins
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Chapman
authors.forename: Christine S
authors.initials: CS
authors.lastname: Ritchie
authors.forename: Donna K
authors.initials: DK
authors.lastname: Arnett
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.forename: Stacey S
authors.initials: SS
authors.lastname: Cofield
authors.forename: H Micheal
authors.initials: HM
authors.lastname: Maetz
mesh_terms: D000407:Alabama; D001291:Attitude of Health Personnel; D003142:Communication; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D017051:Hospice Care / Q000458:organization & administration*; D006801:Humans; D006278:Medicare / Q000191:economics; D010820:Physicians; D011369:Professional-Patient Relations; D012111:Residence Characteristics; D013997:Time Factors; D035502:Trust; D014481:United States