Quality Indicators for End-of-Life Care in Vulnerable Elders

Care for vulnerable elders, many of whom may be near the end of life, has come under increasing scrutiny in the past decade. Studies demonstrate inadequate quality of care with regard to symptom control, matching of care with patient preferences, and optimal resource use at the end of life. In this paper the authors report on 14 indicators developed to identify quality end-of-life care for vulnerable elders. The indicators, which aim to assess the provision of care to achieve a "good death," focus on patient preferences for care and on palliation. Because of the lack of clinical trial evidence relevant to end-of-life care, most of the indicators reported in this paper are based on observational data and Care for vulnerable elders, many of whom may be near the end of life, has come under increasing scrutiny in the past decade. Studies demonstrate inadequate quality of care with regard to symptom control, matching of care with patient preferences, and optimal resource use at the end of life. In this paper the authors report on 14 indicators developed to identify quality end-of-life care for vulnerable elders. The indicators, which aim to assess the provision of care to achieve a "good death," focus on patient preferences for care and on palliation. Because of the lack of clinical trial evidence relevant to end-of-life care, most of the indicators reported in this paper are based on observational data and consensus opinion.