RAND Research Topic: End-of-Life Care 2012-05-24T14:13:27Z Copyright (c) 2012, The RAND Corporation RAND Corporation http://www.rand.org/topics/end-of-life-care.html Development of a Prognostic Model for Six-Month Mortality in Older Adults with Declining Health http://www.rand.org/pubs/external_publications/EP20120057.html Mar 1, 2012 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. Quality of End-of-Life Care for Patients with Advanced Cancer in an Academic Medical Center http://www.rand.org/pubs/external_publications/EP201100249.html Apr 1, 2011 Apr 1, 2011 Cancer Quality-ASSIST indicators are useful for practical quality assessment of cancer end-of-life care in an academic medical center. Communication with Families Facing Life-Threatening Illness: A Research-Based Model for Family Conferences http://www.rand.org/pubs/external_publications/EP201100250.html Mar 31, 2011 Mar 31, 2011 <p>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.</p> Missed Opportunities: Use of an End-of-Life Symptom Management Order Protocol Among Inpatients Dying Expected Deaths http://www.rand.org/pubs/external_publications/EP201100248.html Mar 31, 2011 Mar 31, 2011 Evaluation of implementation of a standardized order set can identify areas for quality improvement and missed opportunities for use. Evaluating a Palliative Care Intervention for Veterans: Challenges and Lessons Learned in a Longitudinal Study of Patients with Serious Illness http://www.rand.org/pubs/external_publications/EP20110047.html Mar 13, 2011 Mar 13, 2011 <p>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.</p> Hospital Spending and Inpatient Mortality: Evidence from California: An Observational Study http://www.rand.org/pubs/external_publications/EP20110016.html Jan 31, 2011 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. Comparing the Costs of Alternative Models of End-of-Life Care http://www.rand.org/pubs/external_publications/EP201100175.html Jan 1, 2011 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. The Impact of Menopause on Health-Related Quality of Life: Results from the STRIDE Longitudinal Study http://www.rand.org/pubs/external_publications/EP201100149.html Dec 31, 2010 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. The Quality of Care for Patients Dying in the Hospital: Areas for Improvement Suggest Fundamental Problem in U.S. Health Care http://www.rand.org/multimedia/video/2010/09/13/quality_care_patients_dying_hospital.html Sep 13, 2010 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. End-of-Life Care in Teaching Hospital Is Generally Good, but More Family Communication Is Needed http://www.rand.org/pubs/external_publications/EP20100093.html Jun 27, 2010 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. Physician Factors Associated with Discussions About End-of-Life Care http://www.rand.org/pubs/external_publications/EP20100144.html Dec 31, 2009 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. Hospice Use and High-Intensity Care in Men Dying of Prostate Cancer http://www.rand.org/pubs/external_publications/EP20100125.html Dec 31, 2009 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. Collateral Damage in the Ruckus Over Healthcare Reform http://www.rand.org/commentary/2009/09/11/CNN.html Sep 10, 2009 Sep 10, 2009 <p>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.</p> The Medicare Hospice Payment System: A Consideration of Potential Refinements http://www.rand.org/pubs/external_publications/EP20090626.html Dec 31, 2008 Dec 31, 2008 <p>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.</p> Hospice and Emergency Room Use By Disadvantaged Men Dying of Prostate Cancer http://www.rand.org/pubs/external_publications/EP20090503.html Dec 31, 2008 Dec 31, 2008 <p>Hospice care has been found to improve symptom management, quality of death and quality of life at the end of life.</p> Inter-vivos Giving By Older People in the United States: Who Received Financial Gifts from the Childless? http://www.rand.org/pubs/external_publications/EP20090014.html Dec 31, 2008 Dec 31, 2008 <p>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.</p> The Impact of Late-Life Parental Death on Adult Sibling Relationships: Do Parents' Advance Directives Help or Hurt? http://www.rand.org/pubs/external_publications/EP20090901.html Dec 31, 2008 Dec 31, 2008 <p>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.</p> The potential cost savings of greater use of home- and hospice- based end of life care in England http://www.rand.org/pubs/technical_reports/TR642.html Nov 29, 2008 Nov 29, 2008 <p>Expansion of home/community end of life services can reduce acute care costs and benefit patients by accommodating expressed preferences on place of death.</p> Paying the Price at the End of Life: A Consideration of Factors That Affect the Profitability of Hospice http://www.rand.org/pubs/external_publications/EP20080920.html Aug 31, 2008 Aug 31, 2008 Evaluates factors that affect the financial performance of hospice. A Systematic Review of Satisfaction with Care at the End of Life http://www.rand.org/pubs/external_publications/EP20080111.html Dec 31, 2007 Dec 31, 2007 <p>More focus on these satisfaction elements might improve the effectiveness of end-of-life interventions and their evaluation.</p>