Palliative Care

Contents:

Research conducted by: RAND Health; RAND Labor and Population

All Items (80)

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

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.

NEWS RELEASE

End-of-Life Care in Teaching Hospital Is Generally Good, but More Family Communication Is Needed — Jun 28, 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

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

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.

JOURNAL ARTICLE

Provider Communication and Patient Understanding of Life-Limiting Illness and Their Relationship to Patient Communication of Treatment Preferences — Dec 31, 2009

Medical decision making in the context of serious illness ideally involves a patient who understands his or her condition and prognosis and can effectively formulate and communicate his or her care preferences.

JOURNAL ARTICLE

Quality of End-of-Life Care in Low-Income, Uninsured Men Dying of Prostate Cancer — Dec 31, 2009

The quality of end-of-life care was assessed in disadvantaged men prospectively enrolled in a public assistance program. That end-of-life care would be aggressive, moreso than recommended by quality-of-care guidelines, was hypothesized.

JOURNAL ARTICLE

Demographic and Social Characteristics and Spending at the End of Life — Dec 31, 2008

In the United States and abroad, the aging of the population and changes in its demographic and social composition raise important considerations for the future of health care and the systems that pay for care.

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

Heart Failure: The Hidden Problem of Pain — Dec 31, 2008

Although dyspnea and fatigue are hallmark symptoms of heart failure (HF), the burden of pain may be underrecognized. This study assessed pain in HF and identified contributing factors.

JOURNAL ARTICLE

A Framework for Assessing Quality Indicators for Cancer Care at the End of Life — Dec 31, 2008

Patients with advanced cancer often do not receive high-quality pain and symptom management or support with coordination of care, communication, and decisionmaking. Posits a conceptual framework for quality indicator development and implementation.

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.

JOURNAL ARTICLE

Progress in Quality-of-Care Research and Hope for Supportive Cancer Care — Dec 31, 2007

Examines progress in supportive cancer care, which encompasses direct and treatment-related impacts of cancer, including management of pain and other symptoms, and the psychosocial context, including spirituality and challenges of caregiving.

JOURNAL ARTICLE

Age and Gender Differences in Medicare Expenditures and Service Utilization at the End of Life for Lung Cancer Decedents — Dec 31, 2007

Gender disparities in expenditures are generally small at the end of life for lung cancer decedents. The bigger observed differences are by age. Higher expenditures for women on social-supportive services may reflect fewer informal supports.

JOURNAL ARTICLE

Improving Generalist End of Life Care: National Consultation with Practitioners, Commissioners, Academics, and Service User Groups — Dec 31, 2007

Definitions of end of life care need clarification and standardisation. A greater evidence base is needed to define models of good practice together with a commitment to provide education and training and adequate resources for service provision. More needs to be known about the context of provision and the influence of competing priorities and incentives.

JOURNAL ARTICLE

Evidence-based Recommendations for Information and Care Planning in Cancer Care — Dec 31, 2007

Domains of information and care planning for high-quality cancer care include integration of palliation, advance care planning, sentinel events as markers for the need to readdress a patient's goals of care, and continuity of care planning.

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Researcher Spotlight

Neil S. Wenger

Director, Assessing Care of Vulnerable Elders (ACOVE) project

Neil S. Wenger

Neil S. Wenger is a professor of medicine at the University of California, Los Angeles (UCLA) and a practicing general internist with an interest in patients with complex illness. He directs the UCLA Health System Ethics Center and the Assessing Care of Vulnerable Elders (ACOVE) project within…

Dmitry Khodyakov

Associate Behavioral & Social Scientist

Dmitry Khodyakov (Ph.D. Sociology, Rutgers University) is an Associate Behavioral/Social Scientist and a faculty member at the Pardee RAND Graduate School. Khodyakov's research focuses primarily on intervention and program evaluation, partnership development and maintenance, expert…

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