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American Journal of Hospice and Palliative Medicine®
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Joining forces, joining futures: Hospice at the crossroads

Julie Pietroburgo, PhD, MPA

Southern Illinois University Edwardsville; Department of Public Administration and Policy Analysis, Edwardsville, Illinois

Faced with health-policy changes, increased competition, and limited funding, hospices must either find more efficient ways to provide end-of-life care or risk organizational demise. Increasingly, hospices are re-evaluating their organizations to stretch resources and remain viable. Prevalent restructuring options for addressing environmental pressures are integration, alliance, and collaboration with other organizations. This study examines the restructuring phenomenon by evaluating trends among nonprofit hospices in six states. The study identifies demographic characteristics predictive of organizational decisions to join forces, and it examines the dominant political and economic reasons that propel or impede restructuring decisions. In addition, the study evaluates the results of restructuring actions.

Key Words: restructuring programs • collaborative care • integrated care • alliance

American Journal of Hospice and Palliative Medicine®, Vol. 21, No. 3, 209-215 (2004)
DOI: 10.1177/104990910402100310


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Home page
AM J HOSP PALLIAT CAREHome page
J. Pietroburgo and R. Bush
Coming to Terms: A Case Study of Hospice Collaboration Challenges
American Journal of Hospice and Palliative Medicine, January 1, 2008; 24(6): 487 - 492.
[Abstract] [PDF]



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