Pietroburgo Julie
Department of Public Administration and Policy Analysis, Southern Illinois University Edwardsville, Edwardsville, Illinois 62026-1457, USA.
Am J Hosp Palliat Care. 2006 Jun-Jul;23(3):217-23. doi: 10.1177/1049909106289088.
A core hospice value is caring for dying individuals regardless of their ability to pay. Historically, a stable source of government funding has provided the financial cushion necessary to extend care to indigent patients. Recently however, 2 factors have challenged the charitable-care value. First, financial reserves have been constrained by regulatory actions limiting admissions, lengths of stay, and reimbursement levels. Second, the number of uninsured individuals has increased. This study of hospices in 17 states found that hospices (1) remain committed to indigent care despite deep concerns about inadequate financial resources, (2) are encountering increased demand for services from indigent patients, (3) are currently covering indigent-care costs, but are pessimistic about their future ability to do so, and (4) are pursuing alternative funding with mixed results.
临终关怀的一个核心价值观是照顾濒死个体，无论其支付能力如何。从历史上看，稳定的政府资金来源提供了必要的经济缓冲，以便为贫困患者提供护理。然而，最近有两个因素对慈善护理价值观构成了挑战。首先，财务储备受到监管行动的限制，这些行动限制了入院人数、住院时间和报销水平。其次，未参保个体的数量有所增加。这项对17个州临终关怀机构的研究发现，临终关怀机构（1）尽管对资金不足深感担忧，但仍致力于贫困护理；（2）贫困患者对服务的需求不断增加；（3）目前正在承担贫困护理费用，但对未来承担这些费用的能力感到悲观；（4）正在寻求替代资金，结果喜忧参半。
