Profit status and delivery of hospice care for infants: the mediating role of pediatric knowledge.

Abstract

Infant mortality is a persistent problem in the United States, and yet, hospice care is rarely provided for infants at the end of life. To examine the influence of profit status on delivery of hospice care for infants, and to explore the mediating role of pediatric knowledge (pediatric program and pediatric knowledge) on the relationship between profit status and the delivery of infant care. Our study was a cross-sectional secondary analysis, using data from the 2008 California State Utilization Data File of Home Health Agencies and Hospice Facilities survey. Of the hospices in the sample, 13% delivered care for infants. Nonprofit hospices were more likely to delivery care for infants (B=0.67, p<0.05), have a specialized pediatric program (B=0.85, p<0.05) and have more experience caring for pediatric patients (B=1.49, p<0.05). Regarding the mediator variables, hospices with a pediatric program were no more likely to deliver care to infants than hospices without a pediatric program (B=0.82, p>0.05). Experience with greater numbers of any pediatric patients facilitated the delivery of hospice infant care in nonprofits (B=0.86, p<0.05). Hospices may need to explore ways to direct resources toward assisting hospice staff members in gaining pediatric experience.