Quality of Palliative Care at US Hospices

Results of a National Survey

Datos Bibliográficos

ID9104340
AutoresMelissa Carlson (0000-0002-8611-3748, Mount Sinai Hospital, autor de correspondencia), Melissa D A Carlson, Colleen L Barry (0000-0001-8211-5036, Johns Hopkins University), Colleen Barry, Mark Schlesinger (0000-0002-7142-8667), Ruth Mccorkle (0000-0001-6578-5441, Yale University), R Sean Morrison (0000-0003-0830-5100, James J. Peters VA Medical Center, autor de correspondencia), Emily Cherlin (0000-0002-9209-9954), Judith Herrin (0000-0002-3671-3622, Yale University), Jeph Herrin, Jennifer Thompson (0000-0003-2921-6887), Martha L Twaddle, Martha Twaddle (0000-0002-1998-3495, Rainbow Hospice and Palliative Care), Elizabeth H Bradley (0000-0003-2592-2741)
Año2011
Volumen49
Número9
Páginas803-809
Fecha de publicación2011-09-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31822395b2
PMID21685811
PMCIDPMC3161163
OpenAlexW1983738518
IdiomaEN
Citas recibidas1
Referencias citadas4

BACKGROUND: The National Quality Forum (NQF) identified hospice services as a national priority area for health care quality improvement and endorsed a set of preferred practices for quality palliative and hospice care. This study reports the first national data regarding hospices' self-reported implementation of the NQF preferred practices and identifies hospice characteristics associated with more comprehensive implementation. METHODS: We conducted a national cross-sectional survey of a random sample of hospices (n=591; response rate, 84%) from September 2008 to November 2009. We evaluated the reported implementation of NQF preferred practices in the care of both patients and families. RESULTS: The range of reported implementation of individual NQF preferred practices among hospices was 45% to 97%. Twenty-one percent of hospices reported having implemented all patient-centered preferred practices, 26% all family-centered preferred practices, and 10% all patient and family-centered preferred practices. In adjusted analyses, large hospices (100 or more patients per day) were significantly more likely than small hospices (<20 patients per day) to report having implemented all patient-centered preferred practices [odds ratio (OR)=2.46; 95% CI, 1.24, 4.90] and all family-centered preferred practices (OR=1.88; 95% CI, 1.02, 3.45). Similarly, chain-affiliated hospices were significantly more likely than free-standing hospices to report having implemented all patient-centered preferred practices (OR=2.45; 95% CI, 1.23, 4.87) and all family-centered preferred practices (OR=1.85; 95% CI, 1.01, 3.41). CONCLUSIONS: Hospices' reported implementation of individual preferred practices for palliative and hospice care quality was high; however, reported comprehensive implementation of preferred practices was rare and may be difficult to achieve for small, free-standing hospices

Best practice · Family medicine · Logistic regression · Management · Odds · Palliative care · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Palliative Care and End-of-Life Issues