Hospice in the United States. Multiple models and varied programs.

This article has reviewed the evolution of hospice care as a discrete cluster of services in the United States from the mid-1960s until the early 1980s. It describes the psychosocial conditions produced by the dominance of cure-oriented medical technology in the medical care system and the reaction to them that hospice programs have come to express. The 6 major organizational models and their minor variations have been described, as were sources and methods of reimbursement until the implementation of the Medicare Hospice Benefit. Finally, the emergence of standards of care for this new service were outlined and the development of the JCAH Hospice Standards and Accreditation mechanism was emphasized.