Organizational Determinants of Hospital End-of-Life Treatment Intensity
Dados Bibliográficos
| ID | 9099573 |
|---|---|
| Autores | Caroline Y Lin (University of Pittsburgh, autor correspondente), Max H Farrell (University of Pittsburgh, autor correspondente), Judith R Lave (University of Pittsburgh, autor correspondente), Derek C Angus (0000-0002-7026-5181, University of Pittsburgh, autor correspondente), Amber E Barnato (0000-0003-1080-6270, University of Pittsburgh, autor correspondente) |
| Ano | 2009 |
| Volume | 47 |
| Fascículo | 5 |
| Páginas | 524-530 |
| Data de publicação | 2009-05-01 |
| Peer Reviewed | Sim |
| Open Access | Não |
| Tipo | ARTICLE |
| Periódico | Medical Care (JOURNAL) |
| Identificadores do periódico | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Editora | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e31819261bd |
| PMID | 19318999 |
| PMCID | PMC2825686 |
| OpenAlex | W2050221782 |
| Idioma | EN |
| Citações recebidas | 1 |
| Referências citadas | 22 |
BACKGROUND: There is substantial hospital-level variation in end-of-life (EOL) treatment intensity. OBJECTIVE: To explore the association between organizational factors and EOL treatment intensity in Pennsylvania (PA) hospitals. RESEARCH DESIGN: Cross-sectional mixed-mode survey of Chief Nursing Officers of PA hospitals linked to hospital-level measures of EOL treatment intensity calculated from PA Health Care Cost Containment Council (PHC4) hospital discharge data. HOSPITALS: One hundred sixty-four hospitals, of which 124 (76%) responded to the survey. MEASURES: : The dependent variable was an index of hospital EOL treatment intensity; the independent variables included administrative data-derived structural and market characteristics and 29 survey-derived hospital or ICU programs, policies, or practices. RESULTS: : In models restricted to independent variables drawn from administrative sources (available for all 164 hospitals), bed size (P < 0.001), proportion of admissions among black patients (P < 0.001), and county-wide hospital market competitiveness (Herfindahl-Hirschman index) (P = 0.001) were independently associated with greater EOL treatment intensity (adjusted R = 0.5136). In models that additionally included hospital programs, policies, and practices (available for 124 hospitals), only an ICU long length of stay review committee (P = 0.03) was independently associated with greater EOL treatment intensity (adjusted R = 0.5357). CONCLUSIONS: Information about hospital and ICU programs, policies, and practices believed relevant to the treatment of patients near the end of life offers little additional explanatory power in understanding hospital-level variation in EOL treatment intensity than administratively-derived variables alone. Future studies should explore the contribution of more difficult to measure social norms in shaping hospital practice patterns
Emergency Medicine · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medicine · Palliative Care and End-of-Life Issues
| Obras citantes distintas | 1 |
|---|---|
| Citações por ano | 0,09 |
| Intervalo de citações | 2015 - 2015 (1) |
| Velocidade de citação | historical |
| Altamente citado | Não |
| Tipos de citação | Neutras: 1 |