Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 Aug;41(8):863-872.
doi: 10.1177/10499091231199722. Epub 2023 Aug 31.

The Efficacy of Hospice-In-Place Care Versus Traditional Inpatient Care

Emily Butler  1 , Claire Hanson  1 , Taaseen Khan  2 , Tuzo Mwarumba  3 , Derek Daniels  2 , Maxim Turchan  1 , Kemberlee Bonnet  4 , David Schlundt  4 , Kelly Harper  1 , Marc Bennett  5 , David Charles  1
Affiliations
Comparative Study

The Efficacy of Hospice-In-Place Care Versus Traditional Inpatient Care

Emily Butler et al. Am J Hosp Palliat Care. 2024 Aug.

Abstract

Introduction: The hospice-in-place program at Vanderbilt University Medical Center (VUMC) is available to patients and families who elect for hospice benefits and are too unstable to be transported for hospice care. The goal of this study was to assess the satisfaction of family members of patients who died while hospitalized at VUMC and received hospice-in-place compared to the families of patients who did not receive hospice care. Methods: Next-of-kin satisfaction was measured through the administration of qualitative interviews and quantitative questionnaires. Semi-structured interviews were audio-recorded, and transcripts were analyzed using an iterative inductive-deductive approach to develop a conceptual framework. Participants were also asked to respond to a 10-question satisfaction questionnaire. Results: Forty participants were enrolled: 20 next-of-kin of patients who received hospice-in-place and 20 next-of-kin of patients who passed without hospice. Factors influencing satisfaction were organized into a conceptual framework with three categories: individual-level factors, systems-level factors, and modifying factors. For the questionnaires, the hospice-in-place group had a mean satisfaction score of 4.54 (0.76) out of five, while the non-hospice group had a mean score of 4.14 (1.00). A comparison of the two groups' responses did not show a statistically significant difference (P = 0.06). Discussion: Quantitative findings of this study showed improved satisfaction but were unable to show a significant difference in satisfaction with hospice-in-place compared to traditional care. Questionnaire results suggest that both types of care yield high satisfaction scores and are successfully supporting patients and families. The conceptual framework also adds to the understanding of end-of-life experiences at VUMC.

Keywords: Hospice-in-place; end-of-life care; family satisfaction; inpatient; next-of-kin; qualitative research.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Integrative conceptual framework of overall satisfaction with end-of-life care.
See this image and copyright information in PMC

References

    1. Wright AA, Zhang B, Ray A, et al. Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA. 2008;300(14):1665-1673. doi:10.1001/JAMA.300.14.1665 - DOI - PMC - PubMed
    1. Ornstein KA, Aldridge MD, Garrido MM, Gorges R, Meier DE, Kelley AS. The association between hospice use and depressive symptoms in surviving spouses. JAMA Intern Med. 2015;175(7):1138. doi:10.1001/JAMAINTERNMED.2015.1722 - DOI - PMC - PubMed
    1. Mason TM, Tofthagen CS, Buck HG. Complicated grief: Risk factors, protective factors, and interventions. J Soc Work End Life Palliat Care. 2020;16(2):151-174. doi:10.1080/15524256.2020.1745726 - DOI - PubMed
    1. Teno JM, Gozalo P, Trivedi AN, et al. Site of death, place of care, and health care transitions among US medicare beneficiaries, 2000. JAMA. 2018;320(3):264. doi:10.1001/JAMA.2018.8981 - DOI - PMC - PubMed
    1. Currow DC, Agar MR, Phillips JL. Role of hospice care at the end of life for people with cancer. J Clin Oncol. 2020;38(9):937-943. doi:10.1200/JCO.18.02235 - DOI - PubMed

Publication types