دورية أكاديمية
أعرض في EDS

Evaluating quality of care at the end of life and setting best practice performance standards: a population-based observational study using linked routinely collected administrative databases.

التفاصيل البيبلوغرافية
العنوان: Evaluating quality of care at the end of life and setting best practice performance standards: a population-based observational study using linked routinely collected administrative databases.
المؤلفون: Oosterveld-Vlug MG; Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands. m.oosterveld@nivel.nl., Heins MJ; Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands., Boddaert MSA; Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands., Engels Y; Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, the Netherlands., Heide AV; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Onwuteaka-Philipsen BD; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands., Reyners AKL; Department of Medical Oncology, Center of Expertise in Palliative Care, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands., Francke AL; Netherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
المصدر: BMC palliative care [BMC Palliat Care] 2022 Apr 12; Vol. 21 (1), pp. 51. Date of Electronic Publication: 2022 Apr 12.
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2002-
مواضيع طبية MeSH: Terminal Care*, Death ; Humans ; Palliative Care ; Retrospective Studies
مستخلص: Background: A high percentage of people dying at home, and a low percentage of people being admitted to hospital and dying there are regarded as indicators of appropriate care at the end of life. However, performance standards for these quality indicators are often lacking, which makes it difficult to state whether an indicator score falls between the ranges of good or poor quality care. The aim of this study was to assess quality indicators concerning place of death and hospital care utilization in people with diseases relevant for palliative care, and to establish best practice performance standards based on indicator scores in 31 regions in the Netherlands.
Methods: A retrospective nationwide population-based observational study was conducted, using routinely collected administrative data concerning persons who died in 2017 in the Netherlands with underlying causes relevant for palliative care (N = 109,707). Data from four registries were linked for analysis. Scores on eight quality indicators concerning place of death and hospital care utilization were calculated, and compared across 31 healthcare insurance regions to establish relative benchmarks.
Results: On average, 36.4% of the study population died at home (range between regions 30.5%-42.6%) and 20.4% in hospital (range 16.6%-25.5%). Roughly half of the population who received hospital care at any time in the last year of life were found to (also) receive hospital care in the last month of life. In the last month, 32.0% of the study population were admitted to hospital (range 29.4-36.4%), 5.3% to an Intensive Care Unit (range 3.2-6.9%) and 23.9% visited an Emergency Department (range 21.0-27.4%). In the same time period, less than 1% of the study population was resuscitated in hospital or received tube or intravenous feeding in hospital.
Conclusions: The variation between regions points towards opportunities for practice improvement. The best practice performance standards as set in this study serve as ambitious but attainable targets for those regions that currently do not meet the standards. Policymakers, healthcare providers and researchers can use the suggested performance standards to further analyze causes of variance between regions and develop and test interventions that can improve practice.
(© 2022. The Author(s).)
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فهرسة مساهمة: Keywords: Benchmarking; End-of-life care; Hospital care; Performance standards; Place of death; Quality indicators; Routinely collected health data
تواريخ الأحداث: Date Created: 20220413 Date Completed: 20220414 Latest Revision: 20220429
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9003976
DOI: 10.1186/s12904-022-00927-2
PMID: 35413862
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-684X
DOI:10.1186/s12904-022-00927-2