End-of-Life Care
2011
Communication with Families Facing Life-Threatening Illness: A Research-Based Model for Family Conferences — 2011
Communication is an ongoing challenge for clinicians working with people facing life-threatening illnesses and end of life. Family conferences offer patient-focused, family-oriented care that brings together patients, family members, and health care providers.
Evaluating a Palliative Care Intervention for Veterans: Challenges and Lessons Learned in a Longitudinal Study of Patients with Serious Illness — 2011
Longitudinal studies examining care for seriously ill patients are needed to understand patients' experience of illness, evaluate interventions, and improve quality of care. Unfortunately, such studies face substantial methodological challenges. This article describes such challenges and the strategies used to overcome them in a successfully implemented palliative care intervention trial for veterans.
Hospital Spending and Inpatient Mortality: Evidence from California: An Observational Study — 2011
High Medicare spending is not associated with better health outcomes at a regional level, but patients admitted to California hospitals from 1999 to 2008 had lower inpatient mortality in those hospitals that spent more on end of life care.
The Impact of Menopause on Health-Related Quality of Life: Results from the STRIDE Longitudinal Study — 2011
Menopause has a negative impact on some domains of health related quality of life (HRQoL), regardless of menopausal symptoms. Clinicians should work to improve HRQoL, rather than expect it to improve spontaneously when menopausal symptoms resolve.
Missed Opportunities: Use of an End-of-Life Symptom Management Order Protocol Among Inpatients Dying Expected Deaths — 2011
Evaluation of implementation of a standardized order set can identify areas for quality improvement and missed opportunities for use.
Quality of End-of-Life Care for Patients with Advanced Cancer in an Academic Medical Center — 2011
Cancer Quality-ASSIST indicators are useful for practical quality assessment of cancer end-of-life care in an academic medical center.
2010
Hospice Use and High-Intensity Care in Men Dying of Prostate Cancer — 2010
This study assessed hospice use by men dying of prostate cancer and compared the use of high-intensity care between those who did or did not enroll in hospice. Those who enroll in hospice are less likely to receive high-intensity end-of-life care.
Physician Factors Associated with Discussions About End-of-Life Care — 2010
Most physicians report they would not discuss end-of-life options with terminally ill patients who are feeling well, instead waiting for symptoms or until there are no more treatments to offer.
The Quality of Care Provided to Hospitalized Patients at the End of Life — 2010
This study of end-of-life care received by hospitalized adults identified deficiencies in planning and palliative care that can be targeted to improve the quality of care for patients dying in the hospital.
2009
Hospice and Emergency Room Use By Disadvantaged Men Dying of Prostate Cancer — 2009
Hospice care has been found to improve symptom management, quality of death and quality of life at the end of life.
The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt? — 2009
The authors examined whether the effect of parental death on adults siblings' relationship quality varies on the basis of the presence and perceived effectiveness of a deceased parent's formal preparations for end-of-life care.
Inpatient Hospital Services: An Update on Services Provided Under California's Workers' Compensation Program — 2009
Examines changes in the number and type of discharges and maximum allowable fees under the California Workers' Compensation Official Medical Fee Schedule for inpatient hospital services from 2003-2005.
The Medicare Hospice Payment System: A Consideration of Potential Refinements — 2009
The purpose of this article is to examine variation in resource utilization across and within patient stays in the context of Medicare's per diem payment system for hospice.
2008
Advance Care Planning Among the Oldest Old — 2008
Even in a system known for high-quality chronic illness care, documentation of advance care planning and proxies for health decisions at end of life was infrequent. Involvement of outpatient primary care and geriatric providers may improve care.
Evidence for Improving Palliative Care at the End of Life: A Systematic Review — 2008
Assesses evidence about interventions to improve palliative and end-of-life care.
Medicare HMO Impact on Utilization at the End of Life — 2008
Medicare beneficiaries who died while enrolled in independent practice association model HMOs, including the Kaiser model, had many fewer hospital days during the two years before death than beneficiaries who died with fee-for-service coverage.
Paying the Price at the End of Life: A Consideration of Factors That Affect the Profitability of Hospice — 2008
Evaluates factors that affect the financial performance of hospice.
A Systematic Review of Satisfaction with Care at the End of Life — 2008
More focus on these satisfaction elements might improve the effectiveness of end-of-life interventions and their evaluation.
Use of Advance Directives for Nursing Home Residents in the Emergency Department — 2008
Finds variability in advance directive documentation for nursing home patients on transfer to the emergency department, and finds that emergency clinicians experience substantial difficulty in reliably obtaining information about advance directives.
2007
Acculturation and End-of-Life Decision Making: Comparison of Japanese and Japanese-American Focus Groups — 2007
Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts.
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