Icahn School of Medicine at Mount Sinai (J.M.R., K.A.O., K.M., R.S.M., M.A.), New York, New York.
Icahn School of Medicine at Mount Sinai (J.M.R., K.A.O., K.M., R.S.M., M.A.), New York, New York.
J Pain Symptom Manage. 2022 Apr;63(4):503-511. doi: 10.1016/j.jpainsymman.2021.12.019. Epub 2021 Dec 23.
Hospice aides provide essential direct care to hospice patients, yet there is minimal research examining hospice aide visits.
describe the prevalence and frequency of hospice aide visits, and 2) evaluate patient, community, and hospice characteristics associated with these visits.
Longitudinal cohort study of Medicare Current Beneficiary Survey (MCBS) participants who died between 2010-2018 and received routine hospice care in the 6 months prior to death (n = 674). We characterized prevalence and frequency of hospice aide visits over time and used generalized linear modelling to identify factors associated with visits.
64% of hospice enrollees received hospice aide visits and average visit frequency (1.3 per week) remained stable throughout enrollment. The only patient characteristic associated with receipt of hospice aide visits was primary hospice diagnosis (respiratory diagnosis vs. dementia: OR 0.372, P = 0.040). Those living in community-based residential housing and those cared for by hospices with aides employed as staff were more likely to receive any hospice aide visits (OR 2.331, P = 0.047 and OR 4.612, P = 0.002, respectively.) CONCLUSION: Hospice aide visits are a common component of hospice care, but visit frequency does not increase as death approaches. Receipt of hospice aide visits was primarily associated with community and hospice agency (rather than patient) characteristics. Future work is needed to ensure that hospice aides are integrated in the hospice interdisciplinary team and that access to hospice aide visits is meaningfully driven by patient and family needs, rather than the practice norms and business models of individual hospice agencies.
临终关怀助理为临终关怀患者提供重要的直接护理，但对临终关怀助理探访的研究甚少。
描述临终关怀助理探访的流行率和频率，并 2）评估与这些探访相关的患者、社区和临终关怀特征。
对 Medicare Current Beneficiary Survey（MCBS）参与者进行的纵向队列研究，这些参与者在 2010-2018 年间死亡，并在死亡前 6 个月内接受常规临终关怀护理（n=674）。我们描述了随时间推移的临终关怀助理探访的流行率和频率，并使用广义线性模型来确定与探访相关的因素。
64%的临终关怀参保者接受了临终关怀助理探访，平均探访频率（每周 1.3 次）在整个参保期间保持稳定。唯一与接受临终关怀助理探访相关的患者特征是主要临终关怀诊断（呼吸诊断与痴呆：OR 0.372，P=0.040）。那些居住在社区居住房屋中的人和由雇佣助理作为员工的临终关怀机构照顾的人更有可能接受任何临终关怀助理探访（OR 2.331，P=0.047 和 OR 4.612，P=0.002，分别）。
临终关怀助理探访是临终关怀护理的常见组成部分，但随着死亡的临近，探访频率并没有增加。接受临终关怀助理探访主要与社区和临终关怀机构（而不是患者）特征相关。未来的工作需要确保临终关怀助理被整合到临终关怀跨学科团队中，并且临终关怀助理探访的获得是由患者和家庭的需求而不是单个临终关怀机构的实践规范和商业模式来真正驱动的。
