Articles: palliative-care.
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J Pain Symptom Manage · Feb 1999
ReviewResearch agenda for developing measures to examine quality of care and quality of life of patients diagnosed with life-limiting illness.
Despite the universality of dying, research has not focused on developing conceptual models and measurement tools for examining the quality of care and quality of life of dying patients and their loved ones. We present here a vision and research agenda for the development of a Tool Kit of Instruments to Measure End of Life Care (TIME). ⋯ For this vulnerable population, research is needed regarding the timing and sources of data collection. In order to achieve maximal benefit, ultimately measurement tools must be incorporated into existing measurement systems and consideration be given to generating informative reports which leads to institutional action to improve the quality of care.
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J Pain Symptom Manage · Feb 1999
ReviewFor every numerator, you need a denominator: a simple statement but key to measuring the quality of care of the "dying".
A mathematical rate is composed of a numerator, denominator, and time period of observation. Deciding who is in the denominator is a key, yet difficult task given the blurred boundaries of chronic illness, in examining the quality of care for dying patients. ⋯ Second, retrospective interviews could be used with family members or other loved ones about their perceptions of the quality of care in the last weeks of life. Improving the quality of care for dying patients and their families requires attention to this matter.
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In 1992 a home care technology project was started in which infusion therapy in the home setting was made available for patients with end-stage cancer. Beside aspects of feasibility and quality of life the resource utilization and costs of this transition was studied. ⋯ Our data suggest that significant savings can be obtained by implementing programs transferring palliative care technology to the home setting.