Grant Number:	1R01CA116398-01A2 Interpret this number
Primary Investigator:	Bradley, Elizabeth
Organization:	Yale University
Project Title:	For-Profit Ownership and End-of-Life Care
Fiscal Year:	2007

DESCRIPTION (provided by applicant): Hospice is an increasingly important aspect of care for patients with cancer and their families; currently, more than half of all patients dying from cancer use hospice. In the last decade, the hospice industry has experienced dramatic growth, in for-profit ownership. The number of for-profit hospices grew 300% while the number of nonprofit hospices grew only 43%. Despite this expansion, we know little about how for-profit ownership affects end-of-life care for patients with cancer and their families. To address this gap in knowledge, we will produce critical evidence about the impact of for-profit hospice ownership on cancer care. Our specific aims are: 1) to determine the association between hospice ownership type and claims-based quality indicators for patients dying from cancer, adjusted for patient and county-level features, and 2) to determine the association between hospice ownership type and additional quality indicators for patients dying from cancer that cannot be assessed with claims data and examine how these associations are modified by other organization-level features. For the first of these specific aims, we have created a unique dataset that has linked the Surveillance, Epidemiology, and End Results-Medicare database with the Medicare Provider of Services data and the Area Resource File and includes detailed clinical and utilization data for 88,293 patients with cancer. For the second specific aim, we will develop, pretest, and field a survey of 500 hospice organizations to evaluate organization-based quality indicators that have been recommended by RAND, the National Quality Forum, and the Institute of Medicine. The phenomenon of increasing for-profit ownership of hospice is dramatic, current, and has potentially far-reaching implications for patients with cancer and their families. At a time when government and employers are looking for private sector solutions to health care problems, it makes sense to ask what impact for-profit hospice ownership has on end-of-life care and to identify opportunities for improving cancer care. Relevance in lay language: We will generate knowledge about the influence of for-profit hospice ownership on the experiences of patients with cancer and their families.




Racial Differences in Health Care Transitions and Hospice Use at the End of Life.
Authors: Wang S.Y. , Hsu S.H. , Aldridge M.D. , Cherlin E. , Bradley E. .
Source: Journal Of Palliative Medicine, 2019 Jun; 22(6), p. 619-627.
EPub date: 2019-01-04 00:00:00.0.
PMID: 30615546
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Associations of Hospice Disenrollment and Hospitalization With Continuous Home Care Provision.
Authors: Wang S.Y. , Dang W. , Aldridge M.D. , Canavan M. , Cherlin E. , Bradley E. .
Source: Medical Care, 2017-07-07 00:00:00.0; , .
EPub date: 2017-07-07 00:00:00.0.
PMID: 28692573
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End-of-life Care Transition Patterns Of Medicare Beneficiaries
Authors: Wang S.Y. , Aldridge M.D. , Gross C.P. , Canavan M. , Cherlin E. , Bradley E. .
Source: Journal Of The American Geriatrics Society, 2017-04-03 00:00:00.0; , .
PMID: 28369785
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Continuous Home Care Reduces Hospice Disenrollment and Hospitalization After Hospice Enrollment.
Authors: Wang S.Y. , Aldridge M.D. , Canavan M. , Cherlin E. , Bradley E. .
Source: Journal Of Pain And Symptom Management, 2016 Dec; 52(6), p. 813-821.
PMID: 27697564
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End-of-Life Care Intensity and Hospice Use: A Regional-level Analysis.
Authors: Wang S.Y. , Aldridge M.D. , Gross C.P. , Canavan M. , Cherlin E. , Johnson-Hurzeler R. , Bradley E. .
Source: Medical Care, 2016 Jul; 54(7), p. 672-8.
PMID: 27111747
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The Impact Of Reported Hospice Preferred Practices On Hospital Utilization At The End Of Life
Authors: Aldridge M.D. , Epstein A.J. , Brody A.A. , Lee E.J. , Cherlin E. , Bradley E.H. .
Source: Medical Care, 2016 Jul; 54(7), p. 657-63.
PMID: 27299952
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Transitions Between Healthcare Settings of Hospice Enrollees at the End of Life.
Authors: Wang S.Y. , Aldridge M.D. , Gross C.P. , Canavan M. , Cherlin E. , Johnson-Hurzeler R. , Bradley E. .
Source: Journal Of The American Geriatrics Society, 2016 Feb; 64(2), p. 314-22.
PMID: 26889841
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Hospice Services for Complicated Grief and Depression: Results from a National Survey.
Authors: Ghesquiere A.R. , Aldridge M.D. , Johnson-Hürzeler R. , Kaplan D. , Bruce M.L. , Bradley E. .
Source: Journal Of The American Geriatrics Society, 2015 Oct; 63(10), p. 2173-80.
PMID: 26456597
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Geographic Variation of Hospice Use Patterns at the End of Life.
Authors: Wang S.Y. , Aldridge M.D. , Gross C.P. , Canavan M. , Cherlin E. , Johnson-Hurzeler R. , Bradley E. .
Source: Journal Of Palliative Medicine, 2015 Sep; 18(9), p. 771-80.
PMID: 26172615
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Massage, Music, and Art Therapy in Hospice: Results of a National Survey.
Authors: Dain A.S. , Bradley E.H. , Hurzeler R. , Aldridge M.D. .
Source: Journal Of Pain And Symptom Management, 2015 Jun; 49(6), p. 1035-41.
PMID: 25555445
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National hospice survey results: for-profit status, community engagement, and service.
Authors: Aldridge M.D. , Schlesinger M. , Barry C.L. , Morrison R.S. , McCorkle R. , Hürzeler R. , Bradley E.H. .
Source: Jama Internal Medicine, 2014 Apr; 174(4), p. 500-6.
PMID: 24567076
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Hospice for nursing home residents: does ownership type matter?
Authors: Canavan M.E. , Aldridge Carlson M.D. , Sipsma H.L. , Bradley E.H. .
Source: Journal Of Palliative Medicine, 2013 Oct; 16(10), p. 1221-6.
PMID: 23895303
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Hospices' enrollment policies may contribute to underuse of hospice care in the United States.
Authors: Aldridge Carlson M.D. , Barry C.L. , Cherlin E.J. , McCorkle R. , Bradley E.H. .
Source: Health Affairs (project Hope), 2012 Dec; 31(12), p. 2690-8.
PMID: 23213153
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Caring for grieving family members: results from a national hospice survey.
Authors: Barry C.L. , Carlson M.D. , Thompson J.W. , Schlesinger M. , McCorkle R. , Kasl S.V. , Bradley E.H. .
Source: Medical Care, 2012 Jul; 50(7), p. 578-84.
PMID: 22310561
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US hospice industry experienced considerable turbulence from changes in ownership, growth, and shift to for-profit status.
Authors: Thompson J.W. , Carlson M.D. , Bradley E.H. .
Source: Health Affairs (project Hope), 2012 Jun; 31(6), p. 1286-93.
PMID: 22665841
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Quality of palliative care at US hospices: results of a national survey.
Authors: Carlson M.D. , Barry C. , Schlesinger M. , McCorkle R. , Morrison R.S. , Cherlin E. , Herrin J. , Thompson J. , Twaddle M.L. , Bradley E.H. .
Source: Medical Care, 2011 Sep; 49(9), p. 803-9.
PMID: 21685811
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The effect of comorbidity burden on health care utilization for patients with cancer using hospice.
Authors: Legler A. , Bradley E.H. , Carlson M.D. .
Source: Journal Of Palliative Medicine, 2011 Jun; 14(6), p. 751-6.
PMID: 21548813
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Experiences of participants in a collaborative to develop performance measures for hospice care.
Authors: Schulman-Green D. , Cherlin E. , Pace K.B. , Hennessy M. , Crocker P.A. , Bradley E.H. .
Source: Joint Commission Journal On Quality And Patient Safety / Joint Commission Resources, 2011 Jan; 37(1), p. 38-44.
PMID: 21306064
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Impact of hospice disenrollment on health care use and medicare expenditures for patients with cancer.
Authors: Carlson M.D. , Herrin J. , Du Q. , Epstein A.J. , Barry C.L. , Morrison R.S. , Back A.L. , Bradley E.H. .
Source: Journal Of Clinical Oncology : Official Journal Of The American Society Of Clinical Oncology, 2010-10-01 00:00:00.0; 28(28), p. 4371-5.
EPub date: 2010-10-01 00:00:00.0.
PMID: 20805463
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Benefits and challenges in use of a standardized symptom assessment instrument in hospice.
Authors: Schulman-Green D. , Cherlin E.J. , McCorkle R. , Carlson M.D. , Pace K.B. , Neigh J. , Hennessy M. , Johnson-Hurzeler R. , Bradley E.H. .
Source: Journal Of Palliative Medicine, 2010 Feb; 13(2), p. 155-9.
PMID: 19827961
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Hospice characteristics and the disenrollment of patients with cancer.
Authors: Carlson M.D. , Herrin J. , Du Q. , Epstein A.J. , Cherlin E. , Morrison R.S. , Bradley E.H. .
Source: Health Services Research, 2009 Dec; 44(6), p. 2004-21.
PMID: 19656230
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