End-of-Life Care

Contents:

Research conducted by: RAND Health

All Items (99)

JOURNAL ARTICLE

Development of a Prognostic Model for Six-Month Mortality in Older Adults with Declining Health — Mar 1, 2012

This study seeks to develop a new prognostic model, the Patient-Reported Outcome Mortality Prediction Tool (PROMPT), for six-month mortality in community-dwelling elderly patients.

JOURNAL ARTICLE

Quality of End-of-Life Care for Patients with Advanced Cancer in an Academic Medical Center — Apr 1, 2011

Cancer Quality-ASSIST indicators are useful for practical quality assessment of cancer end-of-life care in an academic medical center.

JOURNAL ARTICLE

Communication with Families Facing Life-Threatening Illness: A Research-Based Model for Family Conferences — Mar 31, 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.

JOURNAL ARTICLE

Missed Opportunities: Use of an End-of-Life Symptom Management Order Protocol Among Inpatients Dying Expected Deaths — Mar 31, 2011

Evaluation of implementation of a standardized order set can identify areas for quality improvement and missed opportunities for use.

JOURNAL ARTICLE

Evaluating a Palliative Care Intervention for Veterans: Challenges and Lessons Learned in a Longitudinal Study of Patients with Serious Illness — Mar 13, 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.

JOURNAL ARTICLE

Hospital Spending and Inpatient Mortality: Evidence from California: An Observational Study — Jan 31, 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.

JOURNAL ARTICLE

Comparing the Costs of Alternative Models of End-of-Life Care — Jan 1, 2011

The authors estimated at pounds 1.8 billion the cost to the taxpayer of care for the 127,000 patients dying from cancer in 2006. The equivalent cost for the 30,000 people dying from organ failure was pounds 553 million. Resources of pounds 16 to pounds 171 million could be released for cancer.

JOURNAL ARTICLE

The Impact of Menopause on Health-Related Quality of Life: Results from the STRIDE Longitudinal Study — Dec 31, 2010

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.

MULTIMEDIA

The Quality of Care for Patients Dying in the Hospital: Areas for Improvement Suggest Fundamental Problem in U.S. Health Care — Sep 13, 2010

In this September 2010 Congressional Briefing, Neil Wenger describes a yearlong study on improving end-of-life care that can help policymakers address payment systems and other issues pertaining to quality of care for critically ill patients.

JOURNAL ARTICLE

End-of-Life Care in Teaching Hospital Is Generally Good, but More Family Communication Is Needed — Jun 27, 2010

Patients admitted to a teaching hospital for an end-of-life illness generally receive high-quality medical care, but there is a need for better communication about family expectations and for timely efforts to keep patients comfortable.

JOURNAL ARTICLE

Physician Factors Associated with Discussions About End-of-Life Care — Dec 31, 2009

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.

JOURNAL ARTICLE

Hospice Use and High-Intensity Care in Men Dying of Prostate Cancer — Dec 31, 2009

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.

COMMENTARY

Collateral Damage in the Ruckus Over Healthcare Reform — Sep 10, 2009

None of us can choose to live forever. But we can, usually, choose how to make the most of our remaining weeks, months, or years. Helping patients choose how to live well at the end of life lies at the heart of advance-care planning, write Steven M. Asch, Karl Lorenz, and Diane Meier.

JOURNAL ARTICLE

The Medicare Hospice Payment System: A Consideration of Potential Refinements — Dec 31, 2008

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.

JOURNAL ARTICLE

Hospice and Emergency Room Use By Disadvantaged Men Dying of Prostate Cancer — Dec 31, 2008

Hospice care has been found to improve symptom management, quality of death and quality of life at the end of life.

JOURNAL ARTICLE

Inter-vivos Giving By Older People in the United States: Who Received Financial Gifts from the Childless? — Dec 31, 2008

Using data for 1996 to 2004 from the United States Health and Retirement Study, this article examines the differences between parents and childless older people in financial transfers to people other than their children.

JOURNAL ARTICLE

The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt? — Dec 31, 2008

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.

REPORT

The potential cost savings of greater use of home- and hospice- based end of life care in England — Nov 29, 2008

Expansion of home/community end of life services can reduce acute care costs and benefit patients by accommodating expressed preferences on place of death.

JOURNAL ARTICLE

Paying the Price at the End of Life: A Consideration of Factors That Affect the Profitability of Hospice — Aug 31, 2008

Evaluates factors that affect the financial performance of hospice.

JOURNAL ARTICLE

A Systematic Review of Satisfaction with Care at the End of Life — Dec 31, 2007

More focus on these satisfaction elements might improve the effectiveness of end-of-life interventions and their evaluation.

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Researcher Spotlight

Karl Lorenz

Affiliated Adjunct Staff

Karl Lorenz

Karl Lorenz, an affiliated adjunct staff member at the RAND Corporation, is a general practitioner and palliative consultant at the VA Greater Los Angeles Healthcare System and an associate professor of medicine at the University of California, Los Angeles. He is also a professor at the Pardee…

Glenn Wagner

Senior Behavioral Scientist

Glenn Wagner

Glenn Wagner is a senior behavioral scientist at the RAND Corporation and a professor at the Pardee RAND Graduate School. He has been involved in clinical and behavioral HIV research for more than 20 years and has extensive experience with both HIV prevention and treatment research. For more…

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