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The Growth of Hospice Care in U.S. Nursing Homes

Use the school Library to find at least one journal article describing a change that occurred in a health care submarket and how this change impacted particular health care institutions.

· The article is attached to this assignment in which to answerer the below questions:

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A cohesive response to the following:

· Identify the submarket you have selected in the first line of your posting.


· Describe the change in the health care submarket you researched this week.


· Explain in economic terms why this change occurred and how it has impacted the larger system. If the journal article does not describe this impact, describe the impact you would expect and provide your rationale.


· Propose one or two ways that health care institutions can actively influence the supply of, or demand for, this good or service.Document Preview:

The Growth of Hospice Care in U.S. Nursing Homes w w w w Susan C. Miller, PhD, Julie Lima, PhD, Pedro L. Gozalo, PhD, and Vincent Mor, PhD OBJECTIVES: To inform efforts aimed at reducing Med- Key words: hospice; nursing homes; end of life; Medi- icare hospice expenditures by describing the longitudinal care; reimbursement policy useofhospicecareinnursinghomes(NHs)andexamining how hospice provider growth is associated with use. DESIGN: Longitudinal study using NH resident assess- ment(MinimumDataSet)andMedicaredenominatorand claims data for 1999 through 2006. SETTING: NHs in the 50 U.S. states and the District of half-million older adults die in U.S. nursing homes Columbia. 1 A(NHs) each year, but although NHs are increasingly PARTICIPANTS: Persons dying in U.S. NHs. 1 sitesofend-of-lifecare, thereareconcernsaboutthequal- MEASUREMENTS: Medicarebene?ciariesdyinginNHs, ityofthatcare.Painassessmentandmanagementareoften receipt of NH hospice, and lengths of hospice stay were 2–8 inadequate, and family members of dying residents re- identi?ed. The number of hospices providing care in NHs port stress due to limited physician visits and insuf?cient was also identi?ed, and a panel data ?xed-effect (within) 9 staf?ng. TheuseofMedicarehospicecaretoaugmentend- regression analysis was used to examine how growth in of-life care in NHs is a viable option for addressing such providers affected hospice use. concerns, and there is a long history of NH–hospice col- RESULTS: Between 1999 and 2006, the number of hos- 10 laborations; in 2004, 78% of U.S. NHs contracted with picesprovidingcareinNHsrosefrom1,850to2,768,and 11 hospice providers. Documented bene?ts of NH hospice rates of NH hospice use more than doubled (from 14% to careprovidedtoNHresidentsincludebetterpainmanage- 33%).Withthisgrowthcameadoublingofmeanlengthsof 12 13 ment, fewerhospitalizations, greaterfamilysatisfaction stay (from 46 to 93 days) and a 14% increase in the pro- 14–16 with end-of-life care, and lower…

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