Journal of palliative medicine
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Randomized Controlled Trial Comparative Study
Race, income, and education: associations with patient and family ratings of end-of-life care and communication provided by physicians-in-training.
Minority race and lower socioeconomic status are associated with poorer patient ratings of health care quality and provider communication. ⋯ Patient race is associated with perceptions of the quality of communication about end-of-life care provided by physicians-in-training, but the association was opposite to our hypothesis and appears to be mediated by socioeconomic status. Family member predictors of these perceptions differ from those observed for patients. Further investigation of these associations may guide interventions to improve care delivered to patients and families.
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Comparative Study
Noncancer hospice care in taiwan: a nationwide dataset analysis from 2005 to 2010.
Abstract Background: The National Health Insurance program (NHI) in Taiwan has provided hospice services since 2000, and it was expanded to noncancer illnesses in September 2009. The issues of noncancer hospice care and the impact of the expanded hospice policy remain unclear. ⋯ The expanded palliative care policy has impacted positively on noncancer hospice care in Taiwan. The terminal noncancer patients had higher risks for short hospice stay, sepsis, nontraumatic shock, and respiratory and heart problems than the cancer subjects. Early referral to hospices is required for terminal patients in Taiwan. The CCI had a limited role for cost/severity evaluations of hospice care.
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The designation of the Catalan Institute of Oncology (Barcelona, Spain) as World Health Organization (WHO) Collaborating Centre for Public Health Palliative Care Programmes (WHOCC-ICO) in February 2008 turns the institution into the first ever center of international reference in regards to palliative care implementation from a public health perspective. The center aims to provide support to countries willing to develop palliative care programs, to identify models of success, to support WHO's policies, and to generate and spread evidence on palliative care. ⋯ Based on new evidence, the center has recently decided to expand its scope by adopting a community-wide chronic care approach which moves beyond cancer and focuses on the early identification of patients with any chronic disease in need of palliative care. Moreover, the center advocates the development of comprehensive models of care that address patients' psychosocial needs. This center's new work plan includes additional significant innovations, such as the startup of the first chair of palliative care in Spain. Such a whole new approach responds to the main challenges of current palliative care.
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Advances in the field of medicine have improved the overall life expectancy in children. Consequently, many children with previously lethal diseases now live into adulthood. ⋯ This report will summarize the urgency for proper transition modalities and then introduce palliative care as a proposed solution for current challenges in transition. Along the way, it will touch on financial and workforce obstacles to this solution and will offer a potential funding option.
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Comparative Study
Outlooks on palliative care: a crosscultural perspective.