Journal of palliative medicine
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Multicenter Study
Improving access to palliative care through an innovative quality improvement initiative: an opportunity for pay-for-performance.
Improving access to palliative care is an important priority for hospitals as they strive to provide the best care and quality of life for their patients. Even in hospitals with longstanding palliative care programs, only a small proportion of patients with life-threatening illnesses receive palliative care services. Our two well-established palliative care programs in large academic hospitals used an innovative quality improvement initiative to broaden access to palliative care services, particularly to noncancer patients. ⋯ Quality improvement strategies that incorporate pay-for-performance incentives can be used effectively to expand palliative care services to underserved populations.
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The aim of this study was to develop a tool to measure the family's difficulties in caring for cancer patients at the end of life at home: Family's Difficulty Scale in end-of-life home care (FDS). ⋯ The validity and reliability of this new instrument were confirmed. This scale should help home care providers to assess and focus on family difficulties and provide individualized care for the family who cares for a patient with terminal cancer at home.
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Comparative Study
The role of race and ethnicity in predicting length of hospice care among older adults.
The purpose of the study was to examine both direct and interactive roles of race/ethnicity with patients' characteristics (age, gender, relationship with caregiver, diagnosis, referral source, and payment type) in predicting length of hospice care. ⋯ In this limited sample of hospice patients, length of stay was longer for minority patients than white patients.
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Prognostic scoring systems are increasingly used in cancer care. One of these systems is the Palliative Prognostic Index (PPI) which is based on clinical findings. Few studies validated the PPI in different settings. Our aim was to test the predictive value of the PPI in an acute cancer care setting. ⋯ The results suggest that the PPI may be helpful for oncologists in predicting survival and in-hospital mortality of patients with advanced cancer in the acute care setting.