title: Access to bereavement services in hospice.
abstract: Hospice bereavement services, though often overlooked in hospice research, are an important area of study due not only to the potential value of bereavement support but also the emphasis placed on such services by the Centers for Medicare and Medicaid Services. Moreover, access to these services is seldom understood or researched. Therefore, using the patient public use file of the 2007 National Home and Hospice Care Survey, we explored the relationships between patient, informal caregiver, and agency characteristics as well as discharges from hospice to gain perspective into bereavement service access to informal caregivers. Findings suggested that death at discharge from hospice may be an important moderator variable between access to hospice bereavement support and many other factors. However, even under controls for death at discharge, two agency characteristics remain significantly associated with access. Bereavement access tends to be more likely in agencies that provide only hospice care as opposed to other services, and in micropolitan agencies. Furthermore, death at discharge is less likely among African Americans, suggesting the value of enhanced culturally-appropriate and more targeted hospice care and hospice bereavement support for this population. Future research should explore the strategies used to effectively deliver bereavement services and how these strategies may benefit from targeted and culturally sensitive approaches.
authors.affiliation: George Mason University.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dean
authors.affiliation: George Mason University.
authors.forename: Katherine
authors.initials: K
authors.lastname: Libby
authors.affiliation: George Mason University.
authors.forename: William J
authors.initials: WJ
authors.lastname: McAuley
authors.affiliation: Potomac, MD.
authors.forename: Joan
authors.initials: J
authors.lastname: Van Nostrand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001601:Bereavement; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000706:statistics & numerical data*; D017051:Hospice Care / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data; D012044:Regression Analysis; D014481:United States / Q000453:epidemiology