A Secondary Analysis of the Intensity of Hospice Visits Among Medicare Decedents in the Last Seven Days of Life by Place of Residence.

Background: In 2016, Medicare finalized the Service Intensity Add-on (SIA) payment policy to increase the intensity of hospice registered nurse (RN) or social worker (SW) visits in the last 7 days of life. The research objective was to compare the intensity of hospice RN or SW visits in the last 7 days of life among older decedents who received a hospice visit, while residing in a traditional home, an assisted living facility, or long-term nursing home.

Methods: A retrospective analysis using 2016-2018 Medicare data of decedents 65 years or older (n= 2 067 863) related to the Medicare SIA payment policy.

Academic-Service Partnerships: Increasing the Advanced Nurse Workforce.

Background: Clinical education placement for advanced practice registered nurse (APRN) students is challenging for most graduate schools of nursing. This study describes the experiences of hospitals that formed academic-service partnerships to facilitate clinical education placement for APRN students.

Method: Hospital staff, schools of nursing administration and clinical faculty staff, clinical preceptors, and APRN students participated in the focus group and interview sessions during the evaluation of the Graduate Nurse Education demonstration project.

Characteristics of Decedents in Home Settings Using Medicare Place of Hospice Service Codes.

Very little is known about the characteristics of the Medicare beneficiaries receiving hospice at home, defined using the Medicare Healthcare Common Procedure Coding System codes, as a traditional home, an assisted living facility, or a nursing home. A secondary analysis of 2015 Medicare data using regression to describe the characteristics of decedents (n = 675 782) in hospice residing in a traditional home, an assisted living facility, and a nursing home was completed. Results suggest that the proportion of Medicare decedents in hospice with more than 180 lifetime days in hospice was highest among those who resided in an assisted living facility (25.

Do Community and Caregiver Factors Influence Hospice Use at the End of Life Among Older Adults With Alzheimer Disease?

Hospice is an underused service among people with Alzheimer disease. This study used the Hospice Use Model to examine community, care recipient, and caregiver characteristics associated with hospice use before death among 145 community-dwelling care recipients with Alzheimer disease and their caregivers. Secondary analysis using logistic regression modeling indicated that older age, male gender, black race, and better functional health of care recipients with Alzheimer disease were associated with a decreased likelihood of using hospice (model = 23.

Use of healthcare access models to inform the patient protection and affordable care act.

Health policy findings on access to care provide more substantive information if linked to a theory that provides meaningful structure and standard definitions. Three theories of access are reviewed here because they have been used to inform health policy: Penchansky's Model, The Institute of Medicine (IOM) Model of Access Monitoring, and The Behavioral Model of Health Services Use. Penchansky's model is useful when subjective experiences with health care access are needed to inform policy makers.