For-profit Agencies Research Articles

Face-to-face fundraising and the dialectics of appearance

ABSTRACT Face-to-face fundraising (F2F) emerged in the 1990s as an innovative mode of charity fundraising, whereby paid fundraisers – often employed through for-profit agencies – solicit members of the public to sign-up for monthly direct-debit payments. Despite its everyday visibility – and public critical reception – this instance of the ubiquitous intersection of humanitarianism and commodification, integral to contemporary capitalism, remains unexplored. This paper fills this gap but, in the process, draws some theoretical lessons germane to this literature and to materialist critique more generally. I argue that the peculiar dialectics of appearance operative in the political economy of F2F resists interpretation in terms of extant conceptual appreciations of other modalities of ‘commodified compassion’ and in materialist conceptual vocabularies in political economy scholarship more broadly. Far from ‘mere appearance’, F2F’s abstract form of ‘shared humanity’ is not simply an ethical veneer to be bypassed in unveiling the concrete (re)production of inequalities in humanity, as is the general tendency in materialist critique. Rather, this appearance is essential for its functioning and those concrete inequalities are written into this form, rather than existing behind/beyond it. This, I suggest, is captured effectively by a ‘dialectical materialist’ take on the Marxian theory of the commodity form.

The undeclared use of third-party service providers in academic publishing is unethical: an epistemic reflection and scoping review.

There is a substantial body of scientific literature on the use of third-party services (TPS) by academics to assist as "publication consultants" in scholarly publishing. TPS provide a wide range of scholarly services to research teams that lack the equipment, skills, motivation, or time to produce a paper without external assistance. While services such as language editing, statistical support, or graphic design are common and often legitimate, some TPS also provide illegitimate services and send unsolicited e-mails (spam) to academics offering these services. Such illegitimate types of TPS have the potential to threaten the integrity of the peer-reviewed scientific literature. In extreme cases, for-profit agencies known as "paper mills" even offer fake scientific publications or authorship slots for sale. The use of such illegitimate services as well as the failure to acknowledge their use is an ethical violation in academic publishing, while the failure to declare support for a TPS can be considered a form of contract fraud. We discuss some literature on TPS, highlight services currently offered by ten of the largest commercial publishers and expect authors to be transparent about the use of these services in their publications. From an ethical/moral (i.e., non-commercial) point of view, it is the responsibility of editors, journals, and publishers, and it should be in their best interest to ensure that illegitimate TPS are identified and prohibited, while publisher-employed TPS should be properly disclosed in their publications.

A Bioeconomic Model of Non-profit and For-profit National Parks Integrating Locals in Biodiversity Conservation

To achieve the conservation goals of national parks, involving locals in park operations provides a win/win approach for local development and wildlife management. However, while some bioeconomic studies examine the effectiveness of biodiversity conservation projects that employ locals, most ignore the direct involvement of local workers in national park operations. Moreover, the existing literature tends to assume that national parks are for-profit organizations, whereas they are generally non-profit entities. In this study, we develop a bioeconomic model to investigate the extent to which involving locals in tourism in a national park managed under two different styles of management (i.e., non-profit and for-profit agencies) influences wildlife conservation. We find certain conditions under which involving locals in national park operations can conserve wildlife. Under these conditions, if wildlife conservation does not reduce agricultural productivity, non-profit agencies raise the utility of locals and promote wildlife conservation more than for-profit agencies. Otherwise, non-profit agencies do not necessarily increase the utility of locals or improve conservation compared with for-profit agencies. In addition, we compare the equilibria under both types of agencies and show that they do not generally achieve the social optimum.

YouTube® in Spanish as a source of information for patients with inflammatory bowel disease

Introduction and aimThe majority of patients with inflammatory bowel disease (IBD) seek information about their disease on the Internet. The reliability, comprehensiveness, and quality of said information in Spanish has not previously been studied. Materials and methodsAn analytic observational study was conducted that included YouTube® videos on IBD available in Spanish, describing general characteristics, engagement, and sources. Standard tools for evaluating reliability (DISCERN), comprehensiveness, and overall quality (Global Quality Score, GQS) were employed. ResultsOne hundred videos were included. Eighty-eight videos consisted of information produced by healthcare professionals (group 1) and 12 included patient opinions (group 2). There were no differences in the median scores for reliability (DISCERN 3 vs 3, p = 0.554) or comprehensiveness (3 vs 2.5, p = 0.768) between the two groups, but there was greater overall quality in the group 2 videos (GQS 3 vs 4, p = 0.007). Reliability was higher for the videos produced by professional organizations (DISCERN 4; IQR 3–4), when compared with healthcare information websites and for-profit agencies (DISCERN 3; IQR 2.5–3.5) (p < 0.001), but the videos with healthcare information website and for-profit sources had a higher quality score (GQS 3 vs 4, p < 0.001). Comprehensiveness scores were similar. ConclusionThe majority of YouTube® videos in Spanish on IBD have good reliability, comprehensiveness, and quality. Reliability was greater for the videos produced by professional organizations, whereas quality was higher for those created from healthcare information websites and for-profit agencies.

YouTube® en español como fuente de información para pacientes con enfermedad inflamatoria intestinal

Introduction and aimThe majority of patients with inflammatory bowel disease (IBD) seek information about their disease on the internet. The reliability, comprehensiveness, and quality of said information in Spanish has not previously been studied. Materials and methodsAn analytic observational study was conducted that included YouTube® videos on IBD available in Spanish, describing general characteristics, engagement, and sources. Standard tools for evaluating reliability (DISCERN), comprehensiveness, and overall quality (Global Quality Score [GQS]) were employed. ResultsOne hundred videos were included. Eighty-eight videos consisted of information produced by healthcare professionals (group1) and 12 included patient opinions (group2). There were no differences in the median scores for reliability (DISCERN: 3 vs 3, P=.554) or comprehensiveness (3 vs 2.5, P=.768) between the two groups, but there was greater overall quality in the group2 videos (GQS 3 vs 4, P=.007). Reliability was higher for the videos produced by professional organizations (DISCERN: 4; IQR: 3-4), when compared with healthcare information websites and for-profit agencies (DISCERN: 3; IQR: 2.5-3.5) (P<.001), but the videos with healthcare information website and for-profit sources had a higher quality score (GQS: 3 vs 4, P<.001). Comprehensiveness scores were similar. ConclusionThe majority of YouTube® videos in Spanish on IBD have good reliability, comprehensiveness, and quality. Reliability was greater for the videos produced by professional organizations, whereas quality was higher for those created from healthcare information websites and for-profit agencies.

Hospice agency characteristics associated with benzodiazepine and antipsychotic prescribing.

Benzodiazepine and antipsychotic medications are routinely prescribed for symptom management in hospice patients, but have significant risks for older adults. We explored the extent to which patient and hospice agency characteristics are associated with variations in their prescribing. Cross-sectional analysis of hospice-enrolled Medicare beneficiaries aged ≥65 years in 2017 (N = 1,393,622 in 4219 hospice agencies). The main outcome was the hospice agency-level rate of enrollees with benzodiazepine and antipsychotic prescription fills divided into quintiles. Rate ratios were used to compare the agencies with the highest and lowest prescription across patient and agency characteristics. In 2017, hospice agency prescribing rates varied widely: for benzodiazepines, from a median of 11.9% (IQR 5.9,22.2) in the lowest-prescribing quintile to 80.0% (IQR 76.9,84.2) in the highest-prescribing quintile; for antipsychotics, it ranged from 5.5% (IQR 2.9,7.7) in the lowest to 63.9% (IQR 56.1,72.0) in the highest. Among the highest benzodiazepine- and antipsychotic- prescribing hospice agencies, there was a smaller proportion of patients from minoritized populations (benzodiazepine: non-Hispanic Black rate ratio [RR] [Q5/Q1] 0.7, 95% CI 0.6-0.7, Hispanic RR 0.4, 95% CI 0.3-0.5; antipsychotic: non-Hispanic Black RR 0.7, 95% CI 0.6-0.8, Hispanic RR 0.4, 95% CI 0.3-0.5). A greater proportion of rural beneficiaries were in the highest benzodiazepine-prescribing quintile (RR 1.3, 95% CI 1.2-1.4), whereas this relationship was not present for antipsychotics. Larger hospice agencies were over-represented in the highest prescribing quintile for both benzodiazepines (RR 2.6, 95% CI 2.5-2.7) and antipsychotics (RR 2.7, 95% CI 2.6-2.8), as were for-profit agencies (benzodiazepine: RR 2.4, 95% CI 2.3-2.4; antipsychotic: RR 2.3, 95% CI 2.2-2.4). Prescribing rates varied widely across Census regions. Prescribing in hospice settings varies markedly across factors other than the clinical characteristics of enrolled patients.

Geographic variation in Medicare home health expenditures.

To quantify geographic variation in home health expenditures per Medicare home health beneficiary and investigate factors associated with this variation. Retrospective study design analyzing US counties in which at least 1 home health agency served 11 or more beneficiaries in 2016. Several sources of 2016 national public data were used. The key variable is county-level Medicare home health expenditures per home health beneficiary. Counties were grouped into quintiles based on per-beneficiary expenditures. Analyses included calculation of coefficients of variation, computation of the ratio of 90th percentile to 10th percentile in expenditures, and linear regression predicting expenditure. The control variables included characteristics of patients, agencies, and communities. Significant variation in home health expenditures was identified across county quintiles, with a 90th-to-10th-percentile expenditure ratio of 2.5. The percentage of for-profit agencies in the lowest quintile was 15.7 compared with 81.7 in the highest quintile of spending. Unadjusted spending differed by $3864 (95% CI, $3793-$3936), compared with $3611 (95% CI, $3514-$3708) in the adjusted model, between counties in spending quintiles 1 and 5. Although state fixed effects explained nearly 20% of the variation in home health expenditures, 42% of the variation remained unexplained. Home health care exhibits considerable unwarranted variation in per-patient expenditures across counties, signifying inefficiency and waste. Given the expected growth in home health demand, strategies to reduce unwarranted geographic variation are needed.

Dilemmas around temporariness and transnational recruitment agencies: the case of migrant caregivers in Taiwan and Germany

ABSTRACT The precarious nature of caregivers’ migration is one of the fundamental characteristics of the growing marketisation of home-based care at the transnational level. Against this background, scholars have dedicated increasing attention to the role of private actors involved in the transnational recruitment/employment of migrant caregivers, such as the for-profit agencies, asking whether these intermediaries are a good or a bad thing. In order to understand the dilemmas facing this complex scenario, we interviewed trade unionists, activists, and academic experts in Taiwan and Germany, both of which are countries where the growing care needs of the ageing population are addressed by employing caregivers from abroad. In these interviews, research participants in both countries strongly criticised the emergence of transnational agencies as influential actors in the field and accused them of reproducing an exploitative temporariness of work for migrant caregivers and of the care services they provide, grounded in the temporary dimension of their mobility patterns. The research participants also evaluated the current situation as they tried to imagine alternative arrangements. Advocates for migrant caregivers’ rights expressed intense frustration at the widespread acceptance of today’s situation but they also suggested that other forms of intermediaries and of temporariness might be developed.

Home Health Agency Ownership and Quality of Care Outcomes Among Medicare Beneficiaries

Medicare restructured home healthcare reimbursement from a cost-basis to a 60- day risk-based prospective payment system (PPS) in 2000 to implement the value-based payment model for home healthcare services. Currently home healthcare market in the U.S. is dominated by the presence of for-profit (FP) agencies instead of being primarily served by not-for-profit (NFP) agencies. Using data from the 2016-2018 OASIS for beneficiaries participated in the Medicare Current Beneficiary Survey (MCBS) (N=6,115), the current study examines whether home health agency ownership status is associated with length of stay (LOS) and discharge outcome Medicare home health care patients. Our first outcome variable is discharge status (modeled via ordered probit) with three categories: discharge to the community, inpatient hospital and other long-term care facilities. The second outcome variable is LOS and two dummy variables LOS ≤ 30 days and LOS ≥ 99 days were modeled via binary probit. The key independent variable was the ownership status of the agency (FP vs. NFP). Patient level covariates includes demographics (age, gender, race/ethnicity, marital status), comorbidity index, agency characteristics (metropolitan statistical area, hospital-based). Patients in FP agencies were 5.1% (p<0.01) less likely to discharge to community, 15.3% (p<0.001) less likely to have LOS ≤ 30 days but 7.5% (p<0.001) more likely to have LOS ≥ 99 higher compared to patients from NFP agencies under the PPS. Our results have important implications for clinicians, patients and healthcare professionals to be cognizant about the influence of agency ownership on the delivery of healthcare services in home healthcare sector.

Association between home health agency ownership status and discharge to community among Medicare beneficiaries

ABSTRACT To investigate the association of ownership status, discharge rate and length of stay (LOS) of home health care (HH) services under the prospective payment system (PPS). We used 2016–2018 Outcome Assessment and Information Set (OASIS) data sets for Medicare beneficiaries. Two outcome variables were investigated: rate of discharge from an HH agency and LOS. Our main independent variable was ownership status: for-profit (FP) versus not-for-profit (NFP). FP agencies were 4.2% (p <.01) less likely to discharge patients to the community but more likely (7.3%; p <.001) to have longer LOS (>99 days) compared to NFPs. Findings that FP agencies were less likely to discharge patients to the community and more likely to have a longer length of stay than NFP agencies have implications for quality of care initiatives by the Medicare Post-Acute Transformation Act 2014.

Ethics in the Hollow State: Distinguishing between Nonprofit and For-Profit Agents of Prisoner Reentry

New public management, a reform movement that shifted the provision of public goods and services towards private institutions, is firmly entrenched in the United States. The Hollow State, a metaphor often used synonymously with contracting out, reflects the growing trend of using non-governmental networks–often nonprofits but also for-profit organizations–to deliver social services to vulnerable groups. This article, which draws from the author’s dissertation, examines differences in nonprofit and for-profit prisoner reentry agencies. The findings suggest that nonprofit/for-profit differences are eroding as the nonprofit sector becomes more competitive with the private sector for government contracts.

Judicial reliance on the executive: tensions, discrepancies and recommendations for court interpreter service delivery models across Australian jurisdictions

ABSTRACT In the past decade, there has been noticeable improvement in judicial attention and attitudes towards court interpreters, reflected in the implementation of various court interpreter protocols and the Recommended National Standards for Interpreters in Courts and Tribunals. However, this article identifies a number of discrepancies and gaps that still exist in the court interpreting framework in Australia. There are discrepancies across jurisdictions in the types of matters for which the court takes responsibility for engaging and paying for interpreters, and significantly different service delivery models for the funding, recruitment, training and coordination of interpreters. This study found a correlation between jurisdictions with centralised interpreting agencies and streamlined funding with courts who are more generous in their provision of interpreters and willingness to engage in innovative approaches such as the Northern Territory duty interpreter system. The article identifies service delivery frameworks which are more likely to enhance consistency and competence in court interpreters, concluding that centralised and government-funded agencies are more appropriate than small private for-profit agencies. The issues identified in relation to service delivery models illustrate judicial reliance on the executive branch of government to ensure a fair trial through the provision of interpreters. There are, however, immediate steps available to the judiciary such as a collection of data and implementation of small-scale duty interpreting, which are likely to precipitate more appropriate executive government policy responses to legal interpreting.

Infection Prevention and Control Policies and Staffing: A National Survey of Home Health Agencies in the United States

Background: Infection prevention and control (IPC) is a national priority in all healthcare settings, and IPC staffing characteristics have been linked to patient safety outcomes. However, there is a lack of knowledge about IPC in home healthcare (HHC), the fastest growing healthcare sector. Our aim was to better understand the current state of IPC in HHC, as well as the HHC staff involved with IPC policy implementation. Methods: A national survey was conducted between October 2018 and November 2019. The participants included (1) agencies recruited from a national HHC conference and (2) a national random sample of 1,501 agencies stratified by census region, ownership status, and rural or urban location. Survey items included staff influenza vaccination policies, antibiotic stewardship, infection surveillance, and IPC staffing. Descriptive statistics were computed, and differences by ownership were calculated using 2 and Student t tests. Results: Of the 535 HHC agencies that responded to the survey (response rate, 33%), 64% were for-profit agencies. Overall, 30.8% of the agencies (17.9% for-profit, 57.6% nonprofit; P &lt; .01) required staff influenza vaccination. Most nonprofit agencies (84.1%) and about half of the for-profit agencies (48.1%) offered free influenza vaccinations to staff (P &lt; .01). During the past influenza season, 62.6% of agencies (81.5% nonprofit vs 51.6% for-profit; P &lt; .01) had 75% of their employees vaccinated for influenza, and 9.3% (2% nonprofit vs 13.5% for-profit; P &lt; .01) reported that they did not track this data. Only 17.9% of HHC agencies used antibiotic prescribing guidelines, and 33.3% reported that they reviewed cases to assess the appropriateness of antibiotic administration and/or indication. Most HHC agencies (86%) reported collecting and reviewing infection data to identify trends, which was often done quarterly or more frequently. Almost every responding agency reported that the staff member in charge of IPC had other responsibilities including administrative, education/training, or quality improvement, and 33.5% of those personnel had received no specific IPC training. Also, ~6% of agencies (12.5% of government-owned agencies) reported that they currently did not have a staff member in charge of IPC. Conclusions: This is the first national study of IPC in HHC, which can be used as a benchmark for quality improvement initiatives in the home care environment. Compared to other healthcare settings, HHC agencies have substantial challenges related to IPC. Most HHC agencies do not have a staff member exclusively dedicated to IPC, and staff training is inadequate. Furthermore, a significant number of agencies have no staff influenza vaccination or antibiotic stewardship policies in place. The situation is worse at for-profit agencies, which dominate the current US HHC industry.Funding: NoneDisclosures: None

Managers, Consumers, Visitors: Roles of Caring Relatives in Emerging Home-based Eldercare in the Czech Republic

Each culture has a deeply rooted understanding of what constitutes the ideal foreldercare organization. This article investigates the role of family members in the delegation and provision of eldercare by private for-profit agencies in the Czech Republic. In this post-socialist country with a high level of intergenerational solidarity, a new market for eldercare has emerged in recent decades. We are interested in how the dominance of the family in eldercare provision is inscribed in the functioning of forprofit agencies and their caring practices. We examine how the role of family members whose elderly relatives receive paid care provided by private for-profit agencies is conceptualized by those who sell the care services, those who provide these services, and the care recipients themselves. We draw upon interviews conducted with the owners of private agencies, ethnographic observations, and informal interviews with paid care workers.

CHANGES IN THE MEDICARE HOME HEALTH CARE MARKET: THE IMPACT OF ACA REIMBURSEMENT POLICY

This study evaluated the effect of recent ACA changes to Medicare Home Health Care (HHC) reimbursements on the mix of agencies and staff in the HHC market. We used Provider of Services (POS) data and logistic regression, to determine which agency characteristics were associated with the likelihood of exiting the HHC market and likelihood of decreasing staff before (n=13,878) and after (n=13,702) implementation of the ACA-mandated reimbursement cuts. Free standing agencies had 1.35 times the odds of exiting from the HHC market post ACA cuts. There were no differences in the odds of exiting the HHC market between for-profit and non-profit agencies. Agencies in the New York, Atlanta, and Chicago regions had a greater likelihood of exiting the HHC market post ACA cuts. Small agencies had two times the odds of exiting (aOR= 2.09) and agencies with one or more branch had less than half the odds of exiting (aOR= 0.46) from the HHC market. The average number of all staff was similar before and after the ACA cuts; however, office staff and home health aides experienced the greatest decrease in number. Agencies that were for-profit, free-standing, small, and/or with one or more branch were more likely to decrease staff post the ACA cuts. Agencies in the New York, Atlanta, Chicago, Dallas and Kansas regions were more likely to decrease staff. Overall, the reimbursement cut effects varied by geographic region and had greater impact on more vulnerable agencies and staff that were non-skilled.

Understanding public health insurance in India: A design perspective.

It is broadly accepted that health policy is crucially affected by contextual conditions. Yet, little is known about how the context limits the effectiveness of public health insurance (PHI) programs and the extent to which these limitations could be overcome. The objective of the paper is to address these issues on the basis of the examination of 17 PHI schemes introduced by federal and state governments in India since independence. Faced with the challenge of simultaneously expanding insurance coverage while containing costs, governments have overwhelmingly favored the latter. At the same time, governments have lacked the capacity to monitor performance, which has led providers to compromise quality in return for low payment rates. While there have been modest improvements in recent years, reform efforts have been hindered by contextual conditions that constrain the use of measures to control profiteering by for-profit agencies. The paper argues that system-wide data on the quality of providers (system-level operational capacity) and the ability of public agencies to monitor quality and link it with payment (organizational-level operational capacity) critically determined the program effectiveness. We demonstrate the interaction between contextual variables, program design elements, and policy capacity linking to performance, arguing for a broader approach to understand PHI performance. We extend the present frameworks on PHI effectiveness that have narrowly focused on the design of health financing functions without factoring unfavorable context and limited policy capacity in developing countries. The paper contributes to improving PHI performance operating in unfavorable contextual conditions in India and elsewhere.

Measuring Quality in Home Healthcare.

Improving quality performance in home health is an increasingly high priority. The objective of this study was to examine trends in industry performance over time using three quality measures: a composite quality metric (Q index), an infection prevention measure (vaccination verification), and an outcome measure (hospital avoidance). We linked Home Health Compare and Provider of Services data from 2012 to 2016, which included 39 211 observations during the 5-year study period and 7670 agencies in 2016. The Q index was developed to allow comparability over time, equally weighting the contributions of each element. After examining summary statistics, we developed three regression models stratified by ownership (for-profit/nonprofit agency) and included two constructs of nurse staffing, in addition to controlling for known confounders. Most agencies (80.4%) were for-profit agencies. The Q index and vaccination verification improved substantially over time, but there was no change in hospital avoidance. Ownership status was associated with all three measures (P < .001). Registered nurse staffing (relative to licensed practical nurses and home health aides) was associated with higher Q index and vaccination verification (P < .001). The Q index allows for assessment of trends over time in home healthcare. Ownership and nurse staffing are important factors in the quality of care. The overall home care market is driven by for-profit agencies, but their characteristics and outcomes differ from nonprofit agencies. J Am Geriatr Soc 67:1859-1865, 2019.

Trends in Hospice Quality Oversight and Key Challenges to Making it More Effective, 2006-2015.

Background: Given the limited ability of hospice patients to assess, monitor, and respond to substandard care, quality oversight has an important role to play in the hospice sector. The IMPACT Act of 2014 required that agencies be recertified at least every three years, but it did not otherwise alter hospice quality oversight. Objectives: To illuminate the current hospice quality oversight process and discuss its role alongside other government monitoring and public reporting efforts. Methods: Retrospective analysis (2006-2015) concerning hospice accreditation status, deficiency trends, survey frequency and deficiency outcomes, and termination from the Medicare program. Results: The proportion of privately accredited hospice agencies increased from 15% to 39%, a trend driven largely by its increased use among for-profit agencies. The combined rate of deficiencies per agency increased 35% over the past decade, with issues around care planning, aide and homemaker services, and clinical assessment featured most prominently. Nearly half (45%) of all surveys resulted in deficiency citations; however, less than one-in-four hospice agencies were surveyed in a given year. Over the past decade, 28 agencies were terminated from the Medicare program; most of these agencies were unaccredited and operated on a for-profit basis. Conclusions: The IMPACT Act addressed one of the biggest shortcomings in hospice oversight. Our findings highlight additional reforms that could be considered. First, reporting inspection results from private and public recertification surveys could promote greater transparency and accountability. Second, making a wider range of intermediate sanctions available to oversight agencies could enhance enforcement efforts and, ideally, incentivize agencies to improve quality of care.

Complaints About Hospice Care in the United States, 2005-2015.

Complaints are an opportunity for patients and family members to report allegations of substandard care. No prior studies have examined complaints in hospice care and what might be learned from them. To describe hospice complaint trends, characterize state investigation practices, and assess the relationship between complaints and hospice agency traits of interest. Retrospective analyses merged hospice complaints from 2005 to 2015 with agency characteristics from Medicare Cost Reports and Provider of Service files. Annual rates of complaint allegations and deficiencies on a per agency and per 10,000 patient days basis, nationally and by state. Likelihood of having any complaint allegations and deficiencies. Mean days to investigation and substantiation rates, by state. Hospice traits of interest were accreditation and profit status. Between 2005 and 2015, a total of 12,931 complaint allegations were received about hospice care, resulting in 6710 complaint deficiencies. Allegations centered on concerns about quality of care (45%), patients' rights (20%), and administrative/personnel concerns (14%). Complaint rates varied across states but were generally quite low-in a given year, 88% of agencies nationally did not have any complaints. Complaint investigation practices varied considerably across states, with 34% of complaints substantiated. For-profit agencies were 1.33 and 1.52 times more likely relative to not-for-profits to have a complaint allegation and deficiency, respectively. Although the number of complaints was low overall, these data have the potential to convey insights about the care that hospice agencies provide. Greater attention to the perspectives of patients and their families, even when focused on shortcomings in care, can help ensure transparency and accountability and promote higher quality hospice care.

Eldercare agencies and the marketing of care work in the Czech Republic: relieving a family burden?

This article focuses on the private for-profit agencies providing eldercare that have recently emerged in the post-socialist Czech Republic, a country with strong familist tendencies in eldercare organisation. We draw upon 10 in-depth interviews with owners of these agencies, focusing on how they create their services, define the care they provide and target potential clients. We also analyse the websites of the selected agencies to investigate how they promote their services online. The main aim of this article is to illuminate the strategies of marketising eldercare in the agencies. We identify the process of the ‘burdenisation’ of eldercare as an outcome of its marketisation.