Leonard Davis School of Gerontology, 5116University of Southern California, Los Angeles, CA, USA.
Family Medicine and Geriatrics, 12223USC Keck School of Medicine, Alhambra, CA, USA.
Am J Hosp Palliat Care. 2022 Nov;39(11):1281-1287. doi: 10.1177/10499091211073462. Epub 2022 Mar 2.
New opportunities to expand home-based palliative care (HBPC) highlight the need for novel data that explores how HBPC providers currently navigate this nascent business.
To investigate how HBPC providers and their organizations sustain their operations in a rapidly evolving market.
This was an exploratory, qualitative study.
We conducted focus groups with staff of nine HBPC organizations that held provider contracts with a large California insurance provider.
A research team member experienced in qualitative methods conducted semi-structured focus group interviews with HBPC agency staff who were knowledgeable about their agency's patient recruitment and enrollment processes. Interview sessions of roughly an hour long were audio-recorded and transcribed verbatim. We used thematic analysis procedures to identify codes and themes.
We identified seven themes: market competition, market diversity, HBPC reimbursement, service standardization, hiring practices, marketing, strategic enrollment processes, and outcomes monitoring. The participants called for more standardization in their field. In discussing key business operations-hiring, marketing, patient enrollment, outcomes monitoring-they demonstrated inventiveness and willingness to innovate in order to succeed in a complex healthcare sector.
Our study expands on the literature by providing a glimpse of the challenges encountered by HBPC providers and their organizations and the myriad strategies they undertake to navigate a health-service area that lacks standardized practice and payment guidelines. Our findings suggest that HBPC agencies will continue to struggle in the absence of standardization in practice, payment, and quality oversight.
扩大居家姑息治疗（HBPC）的新机会突显了需要新的数据，以探讨 HBPC 提供者如何在这个新兴的市场中进行导航。
调查 HBPC 提供者及其组织如何在快速发展的市场中维持其运营。
这是一项探索性的定性研究。
我们与九家与加利福尼亚州一家大型保险公司签订提供商合同的 HBPC 组织的工作人员进行了焦点小组讨论。
一位具有定性方法经验的研究团队成员对了解其机构患者招募和登记流程的 HBPC 机构工作人员进行了半结构化焦点小组访谈。大约一个小时的访谈会议进行了录音，并逐字转录。我们使用主题分析程序来识别代码和主题。
我们确定了七个主题：市场竞争、市场多样性、HBPC 报销、服务标准化、招聘实践、营销、战略登记流程和结果监测。参与者呼吁在他们的领域实现更多的标准化。在讨论关键业务运营——招聘、营销、患者登记、结果监测——他们表现出了创造力和创新意愿，以便在复杂的医疗保健领域取得成功。
我们的研究通过提供 HBPC 提供者及其组织所面临的挑战的视角，以及他们为在缺乏标准化实践和支付指南的卫生服务领域进行导航而采取的各种策略，扩展了文献。我们的研究结果表明，在实践、支付和质量监督缺乏标准化的情况下，HBPC 机构将继续面临困难。
