Rural Health Research Gateway

Hospice and palliative care

Publications

Listed by publication date. You can also view these publications alphabetically.

2007

  • Ambulatory Care Sensitive Condition Hospitalizations Among Rural Children (Brief)
    Author(s): Michelle Casey, Alana Knudson, Michele Burlew, Gestur Davidson
    Research center: Upper Midwest Rural Health Research Center
    Topics: Children, Chronic diseases and conditions, Hospice and palliative care
    Report Number: Policy Brief
    Date: 06 / 2007
    Reports results from a study examining children's inpatient hospitalizations for Ambulatory Care Sensitive Conditions (ACSCs), rural residence, poverty, health insurance, and physician supply. Admission rates for five conditions were examined: asthma, diabetes short-term complications, gastroenteritis, urinary tract infection and perforated appendix.

2005

  • Providing Hospice Care in Rural Areas: Challenges and Strategies to Address Them
    Author(s): Michelle M. Casey, Ira S. Moscovice, Beth A. Virnig, Sara B. Durham
    Research center: Minnesota Rural Health Research Center
    Topics: Health services, Hospice and palliative care
    Citation: American Journal of Hospice and Palliative Medicine, 22(5), 363-8
    Date: 2005
    Hospices in rural settings face challenges in the provision of hospice care as a result of their location and the size of their service area population. To ascertain the challenges that hospices face in serving rural communities, researchers conducted in-depth case studies of four different models of hospice care in rural areas. The authors describe strategies used by the case study hospices and recommend policies that could increase access to hospice care for rural Medicare beneficiaries and other rural residents. National initiatives to improve end-of-life care need to consider the special challenges faced by rural hospices.

2004

  • Do Rural Elders Have Limited Access to Medicare Hospice Services?
    Author(s): Beth A. Virnig, Ira S. Moscovice, Sara B. Durham, Michelle M. Casey
    Research centers: Minnesota Rural Health Research Center, Upper Midwest Rural Health Research Center
    Topics: Aging, Hospice and palliative care, Medicare
    Citation: Journal of the American Geriatrics Society, 52(5), 731-5
    Date: 2004
    The authors examined whether there are urban-rural differences in use of the Medicare hospice benefit before death and whether those differences suggest that there is a problem with access to hospice care for rural Medicare beneficiaries. Rates of hospice care before death were negatively associated with degree of rurality. The lowest rate of hospice use, 15.2% of deaths, was seen in rural areas not adjacent to an urban area. The highest rate of use, 22.2% of deaths, was seen in urban areas. Rural areas adjacent to urban areas had an intermediate level of hospice use (17.0% of deaths). Hospices based in rural areas had a smaller number of elderly patients each year than hospices based in urban areas, and were more likely to have very low volumes. The authors conclude that the consistently lower use of Medicare hospice services before death and smaller sizes of rural hospices suggests that the combination of Medicare hospice payment policies and hospice volumes are problematic for rural hospices. Adjusting Medicare payment policies might be a critical step to assure availability of hospice services for terminally ill beneficiaries regardless of where they live.

2002

  • Use of the Hospice Benefit by Rural Medicare Beneficiaries
    Author(s): Beth Virnig, Ira Moscovice, Sara Kind, Michelle Casey
    Research center: Minnesota Rural Health Research Center
    Topics: Hospice and palliative care, Medicare
    Date: 08 / 2002
    Identifies urban-rural differences in hospice use in rural service areas.