Background: Several studies chronicle profit-making negatively impacting US hospice care quality. However, no study has reported on caregiver satisfaction expressed online by hospice.
Objectives: Assess the relationship between online caregiver sentiment, market share, profit status, and Consumer Assessment of Healthcare Providers and Systems (CAHPS scores among the 50 largest US hospices.
Methods: Retrospective mixed methods of sentiment and multivariate regression analysis. Data sources were online caregiver reviews, provider CAHPS hospice survey data.
Results: Being a larger, for-profit predicted diminished caregiver and employee satisfaction. and were so highly associated ( = .862, < .001), that they are converging on overall caregiver satisfaction. With large effect, was significantly higher than . For-profits had significantly higher overall than non-profit hospices, again with large effect. , and each predicted was more frequent among for-profits (13%) than non-profits (6%). prevalence was 9%.
Conclusion: Caregiver and employees had better experiences with non-profits than for-profits. Anger and frustration was expressed toward large, for-profit providers more focused on admissions, profiteering, and paying dividends than actual care. The CAHPS appears to draw more satisfied caregivers. Whereas, online reviewing provides open-ended, real-time voicing of care quality concerns. Even with distinct methods, CAHPS survey and review sentiment analysis converge on caregiver satisfaction, yet CAHPS paints a much rosier picture of hospice quality than online reviews. Future research should explore sentiments by topic and hospice to increase customer advocacy.
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