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End-of-Life Care

Individuals with a terminal illness, and the caregivers in their families, face many challenging questions, and the health care they receive can vary widely. For practitioners and policymakers seeking to better understand end-of-life care concerns, RAND researchers address a range of pertinent topics, including quality of care, costs, patient preferences, pain management, best practices, treatment disparities, and access requirements.

News Release

Growing Evidence Supports Best Practices in Palliative Care

A rapidly aging U.S. population with complex care needs will likely accelerate emphasis on palliative care services. A review of palliative care research found substantial evidence to support clinical practice guidelines and was incorporated into the new edition of the guidelines.

Oct 31, 2018
Periodical

Periodical

RAND Review: March-April 2018

This issue features a Q&A with Michael Rich, Soledad O'Brien, and Francis Fukuyama on the perils of truth decay, and a story on the trend toward unretirement among U.S. workers. The Voices column features Gulrez Shah Azhar on environmental refugees.

Mar 5, 2018
Journal Article

Journal Article

Black And Hispanic Patients Receive Hospice Care Similar To That Of White Patients When In The Same Hospices

Black and Hispanic patients received care from poorer quality hospices than white patients.

Aug 1, 2017
Journal Article

Journal Article

Medicare Beneficiaries With Advanced Lung Cancer Experience Diverse Patterns Of Care From Diagnosis To Death

The substantial variations across sites in patterns of end-of-life care for patients with cancer should be factored in to efforts to improve care.

Aug 1, 2017
Journal Article

Journal Article

End-Of-Life Medical Spending In Last Twelve Months Of Life Is Lower Than Previously Reported

Spending in the last year of life accounts for about 10% of overall costs, but spending in the last three years of life can be as high as 25% of total costs, suggesting the need to reduce the costs of caring for people with chronic conditions.

Jul 27, 2017
Journal Article

Journal Article

End-of-Life Care Planning in Accountable Care Organizations: Associations with Organizational Characteristics and Capabilities

About 60 % of Accountable Care Organizations (ACOs) have some kind of end-of-life care planning processes in place, but only about 20% have established advanced planning processes.

Jul 18, 2017
News Release

News Release

Black and Hispanic Patients More Likely to Use Lower-Quality Hospices

Black and Hispanic patients are more likely to receive care from poorer-quality hospices. And their family caregivers are less likely to receive the right amount of emotional and religious support in hospice care. However, caregivers of black and Hispanic patients report similar or better experiences than caregivers of white patients within a given hospice.

Jul 5, 2017
Journal Article

Journal Article

Development and Feasibility of a Structured Goals of Care Communication Guide

Studies demonstrate the benefits of discussing goals of care and advance care planning, yet many patients with serious illness do not engage in such discussions with healthcare providers.

May 30, 2017
Journal Article

Populations and Interventions for Palliative and End-of-Life Care: A Systematic Review

This evidence review found that palliative care improves outcomes for cancer, dementia, congestive heart failure, and chronic obstructive pulmonary disease.

Sep 12, 2016
Journal Article

Journal Article

Factors Associated with Family Reports of Pain, Dyspnea, and Depression in the Last Year of Life

Family reports of patients' experiences with pain, difficult breathing, and depression near the end of life suggest strategies at the clinical and population level for assessing and managing symptoms.

Aug 23, 2016
Report

Report

Agreement with, and feasibility of, the emerging recommendations from the Living with Breathlessness study: Findings from an online stakeholder survey

This report contains the findings from an online survey of stakeholders who work with people living with advanced COPD to explore agreement with, and feasibility of the recommendations from the Living with Breathlessness study.

Jun 6, 2016
Journal Article

Journal Article

The Future as a Series of Transitions: Qualitative Study of Heart Failure Patients and Their Informal Caregivers

Patients and caregivers view heart failure as a series of transitions, including the shock of first being diagnosed; learning to adjust to life with heart failure; reframing and taking back control of one's life; and understanding and accepting that death is inevitable.

May 1, 2016
Journal Article

Journal Article

The Lack of Documentation of Preferences in a Cohort of Adults Who Died After Ischemic Stroke

Stroke patients' wishes to limit life-sustaining interventions were documented in less than 40 percent of cases in which patients died 30 days after hospital admission.

Apr 22, 2016
Journal Article

Journal Article

A Qualitative Inquiry on Palliative and End-of-Life Care Policy Reform

Despite recent broad interest in reforming end-of-life care policies, the palliative care field faces many challenges to expanding use.

Apr 20, 2016
Journal Article

Journal Article

A Systematic Review of Family Meeting Tools in Palliative and Intensive Care Settings

We systematically reviewed PubMed for articles describing family meeting tools and abstracted information on tool type, usage, and content.

Feb 22, 2016
Journal Article

Journal Article

A Hospital-Based Advance Care Planning Intervention for Patients with Heart Failure: A Feasibility Study

The purpose of this study was to evaluate the feasibility of implementing a multiple-component hospital-based intervention on completion of ACP forms among HF patients.

Feb 18, 2016
Journal Article

Family Perspectives on Aggressive Cancer Care Near the End of Life

This study aims to assess the association of aggressive end-of-life care with bereaved family members' perceptions of the quality of end-of-life care and patients' goal attainment.

Jan 28, 2016
Periodical

Periodical

RAND Review: September-October 2015

This issue of RAND Review reports on the staggering costs of dementia in the United States; the most critical global choices and challenges the next U.S. president will likely face; tips to protect the health of kids heading back to school; and more.

Aug 21, 2015
Commentary

Medicare at 50: How Reforming End-of-Life Care Could Benefit It for Years to Come

As Medicare turns 50, skyrocketing health care costs and the aging of baby boomers both threaten the program's long-term viability. One solution that could go a long way would be to change the way the program handles and pays for end-of-life care.

Jul 30, 2015
Journal Article

Journal Article

Association of Early Patient-Physician Care Planning Discussions and End-of-Life Care Intensity in Advanced Cancer

Early patient-physician care planning discussions may influence the intensity of end-of-life (EOL) care received by veterans with advanced cancer.

Jul 28, 2015

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RAND Topic:
End of Life Care

Topic Synonyms:
End-of-Life Care;
EOL;
Terminal Care

Research conducted by