Hospice Care--A Growing Concept in the United States

HRD-79-50: Published: Mar 6, 1979. Publicly Released: Mar 6, 1979.

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Hospices in the United States were reviewed to determine the number of operating hospices and the number in the developmental stage, to describe the characteristics of the patients served by the hospices, to determine State licensure and health planning requirements for hospices, and to identify hospices' operating costs and sources of funds.

In most States hospices are covered under licensing and certificate of need laws for the traditional levels of care they provide, inpatient hospital, skilled nursing facility, and home health care. The cost of establishing and operating a hospice appears to depend primarily on the type of facility, if any, used; the range of services provided; and the ratio of paid staff to volunteers. Medicare, Medicaid, Social Services, and programs authorized under the Older Americans Act can pay for at least some of the services provided by hospices, but laws governing these programs would probably need to be amended to cover all hospice services, especially those provided to families. Costs at the various levels of care should be relatively comparable between hospices and traditional providers; any savings would depend on their ability to care for patients at a lower level of care (skilled nursing or intermediate care instead of hospital, or home health instead of skilled nursing).

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