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End-of-Life Care

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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
Commentary
COVID-19 and End-of-Life Decisions
Resuscitative efforts do not typically save a life. In anticipation of the pandemic surge, hospitals are discussing blanket do-not-resuscitate orders for patients dying from the coronavirus. It's time to discuss the limits of CPR so patients stricken with COVID-19 can make informed end-of-life decisions.
Apr 30, 2020

Explore End of Life Care

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
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
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
Journal Article
A Scalable Web-Based Module for Improving Surgical and Medical Practitioner Knowledge and Attitudes About Palliative and End-of-Life Care
We built a web-based, interactive, self-directed learning module about end-of-life care.
Jul 16, 2015
Commentary
Let People Make Their Own End-of-Life Decisions
Major advances in health technology have helped people to live longer, but not necessarily better, lives. Medicare recently announced plans to reimburse providers for time spent counseling patients and their caregivers about the kind of care patients would want to receive near the end of their lives.
Jul 15, 2015
Dissertation
Go Gentle into That Good Night: The Past, Present, and Future of End-of-Life Care
Examines the past, present, and future of end-of-life care in order to shed light on the most effective ways to organize and deliver it.
May 26, 2015
Commentary
He Lived Cautiously, and Then Died Suddenly
After his father's unexpected death, RAND's Jeffrey Wasserman questions his instinct to always play it safe, and decides what risks in life are worth taking.
May 15, 2015
Journal Article
The Frequency and Cost of Treatment Perceived to Be Futile in Critical Care
Physicians often perceive as futile intensive care interventions that prolong life without achieving an effect that the patient can appreciate as a benefit.
Apr 29, 2015
Journal Article
Factors Associated with Palliative Withdrawal of Mechanical Ventilation and Time to Death After Withdrawal
In imminently dying patients, mechanical ventilation withdrawal is often a comfort measure and avoids prolonging the dying process.
Apr 29, 2015
Journal Article
The Opportunity Cost of Futile Treatment in the ICU
Futile critical care was associated with delays in care to other patients.
Apr 28, 2015
Journal Article
Measuring Experience with End-of-Life Care: A Systematic Literature Review
We conducted a systematic review of PubMed, PsycINFO, and PsycTESTS for all English-language articles published after 1990 using instruments to measure adult patient, family, or informal caregiver experiences with end-of-life care.
Mar 15, 2015
Journal Article
Symptom Trends in the Last Year of Life from 1998 to 2010: A Cohort Study
The authors describe changes in pain intensity and symptom prevalence during the last year of life from 1998 to 2010.
Feb 11, 2015
Journal Article
The Invisible Homebound: Setting Quality-of-Care Standards for Home-Based Primary and Palliative Care
This article describes the current status of home-based medical care in the United States and offers a brief narrative of a fictional homebound patient and the health events and fragmented care she faces.
Jan 8, 2015
Report
Hospice Experience of Care Survey: Development and Field Test
This report describes development of the Hospice Experience of Care Survey, field test design, procedures, analytic methods and findings, and the final survey for national implementation by the Centers for Medicare & Medicaid Services.
Aug 8, 2014
Journal Article
Transforming Nurse Home Culture: Evidence for Practice and Policy
The nursing home culture change movement aims to improve resident quality of life and quality of care by emphasizing the deinstitutionalization of nursing home culture and focusing on person-centered care.
Feb 1, 2014
Brochure
Assessing Patients' Experiences with Care
Understanding how patients experience care can encourage delivery of high-quality services. It also helps payers, including the Centers for Medicare & Medicaid Services, ensure that they pay for effective and efficient care.
Jun 26, 2013
Blog
When CPR Is the Wrong Call: Mistaking Medical Treatment for Care
If a medical treatment worked only a fraction of the time and resulted in bad outcomes more often than not, practitioners would not make this treatment the default approach. Yet that is exactly what has happened when it comes to CPR for individuals 85 years and older who suffer cardiac arrest in a community setting.
Mar 14, 2013
Journal Article
Care Experiences of Managed Care Medicare Enrollees Near the End of Life
Research based primarily on reports from an individual's surviving relatives often suggests that end-of-life care experiences are particularly poor. However, this examination of reports from patients found that those who died within a year of being surveyed reported slightly better experiences than other enrollees.
Feb 4, 2013

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RAND Topic:
End of Life Care

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

Research conducted by

RAND Health Care

Researcher Spotlight

Julia Bandini

Associate Behavioral and Social Scientist

Julia Bandini is an associate behavioral and social scientist at the RAND Corporation and a professor of policy analysis at the Pardee RAND Graduate School. Her research centers around care for vulnerable and seriously-ill individuals including end-of-life care, palliative and hospice care, and…
Denise D. Quigley

Senior Policy Researcher

Denise D. Quigley is a senior health policy researcher at the RAND Corporation, professor at Pardee RAND Graduate School, and quality improvement (QI) team lead for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) project. Her research focuses on factors influencing health…

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