Tuesday, April 7, 2015

Five Year Snapshot of Hospice Industry - What Does It Say About the Spread of Palliative Care?

Hospices and hospitals are the two principal organizational models delivering palliative care. The Center to Advance Palliative Care (CAPC) has consistently documented, through its regular studies, the growth of hospital-sponsored palliative care services over the most recent five years. During the same period, little has changed among certified hospices.

A close look at NHPCO’s Annual Facts and Figures Reports from 2009 and 2014 tells a lot (note:2014 report, which captures data from 2013, is most recent Report published by NHPCO).
From 2009 to 2014,

  • ·        % of decedents enrolled on hospice benefit for 7 days or less remained steady at 35%
  • ·         median length-of-stay fell slightly to 18.5 days from 21.3
  • ·         % of hospices with fewer than 500 admissions per year rose slightly to 79% from 77%. 45% of hospices admit fewer than 3 patients per week
  • ·         median Average Daily Census (ADC) served by hospices increased notably, to 79.5/day, up from 60/day
  • ·         % of total hospice billed at General Inpatient (GIP) days  jumped to 4.8, up from 2.9.


So, short-stays persist, as do subscale hospices. I believe there is a correlation.  And I also believe that the subscale, and highly competitive, nature of the hospice organizational structure inhibits the spread of palliative care.

On the promising side, larger hospices are getting larger. I describe this development as promising because size does bring proficiency (read this previous post on my reasoning about minimum volume thresholds).

In a 2010 post on this blog (read here), a similar five-year snapshot was taken. Taken together, one could conclude that little has changed over the past 10 years in the hospice industry.


Your thoughts and comments are invited.

6 comments:

newton juma said...

Palliative care indeed is proving to be of great assistance to patients faced with life threatening diseases. In Kenya, efforts are being made to include palliative care in all major hospitals in the country.Newton@ Kenyatta University School of Medicine

Giovana said...

It's so interesting to read about hospice and palliative care statistics. The blog posts says that it hasn't changed much over the last ten years? I wonder how that will change in the next twenty years as the population ages. Hospice and palliative care really does help those who are facing death within a matter of weeks or days. http://cshospice.org/

Christopher Howell said...

This is actually really great news and I'm really happy that the larger hospices are growing! I find that palliative care is really great and I'm glad that it is getting at least somewhat more successful. Let's hope it will continue to grow and become more and more involving in the medical field. http://cshospice.org/

Hospice Valley said...

I used to work at a Hospice in San Fernando Valley. I noticed that a lot of clients prefer to stay at home and get hospice or palliative care there.

faryal naaz said...
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