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Exploring the association of hospice care on patient experience and outcomes of care.

Abstract：

OBJECTIVE:To examine the association of the use of hospice care on patient experience and outcomes of care. Promoting high-value, safe and effective care is an international healthcare imperative. However, the extent to which hospice care may improve the value of care is not well characterised. METHODS:A secondary analysis of variations in care was conducted using the Dartmouth Atlas Report, matched to the American Hospital Association Annual Survey Database to abstract organisational characteristics for 236 US hospitals to examine the relationship between hospice usage and a number of variables that represent care value, including hospital care intensity index, hospital deaths, intensive care unit (ICU) deaths, patient satisfaction and a number of patient quality indicators. Structural equation modelling was used to demonstrate the effect of hospice use on patient experience, clinical and efficiency outcomes. RESULTS:Hospice admissions in the last 6 months of life were correlated with a number of variables, including increases in patient satisfaction ratings (r=0.448, p=0.01) and better pain control (r=0.491, p=0.01), and reductions in hospital days (r=-0.517, p=0.01), fewer hospital deaths (r=-0.842, p=0.01) and fewer deaths occurring with an ICU admission during hospitalisation (r=-0.358, p=0.01). The structural equation model identified that use of hospice care was inversely related to hospital mortality (-0.885) and ICU mortality (-0.457). CONCLUSIONS:The results of this investigation demonstrate that greater use of hospice care during the last 6 months of life is associated with improved patient experience, including satisfaction and pain control, as well as clinical outcomes of care, including decreased ICU and hospital mortality.

journal_name

BMJ Support Palliat Care

journal_title

BMJ supportive & palliative care

authors

Kleinpell R,Vasilevskis EE,Fogg L,Ely EW

doi

10.1136/bmjspcare-2015-001001

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

e13

issue

1

eissn

2045-435X

issn

2045-4368

pii

bmjspcare-2015-001001

journal_volume

9

pub_type

杂志文章

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