Abstract
ObjectivesFinancial pressures and competing demands for limited resources highlight the importance of defining the unmet need for specialty inpatient palliative care (PC), demonstrating the value of the service line and making decisions about staffing. One measure of access to specialty PC is penetration, the percentage of hospitalised adults receiving PC consultations. Although useful, additional means of quantifying programme performance are required for evaluating access by patients who would benefit. The study sought to define a simplified method of calculating unmet need for inpatient PC.MethodsThis retrospective observational study analysed electronic health records from six hospitals in one health system in Los Angeles County.Unmet need for PC was defined by the number of hospitalised patients with four or more chronic serious comorbidities without a PC consultation divided by a denominator of all patients with one or more chronic serious conditions (CSCs) without a PC during the hospitalisation.ResultsThis calculation identified a subset of patients with four or more CSCs that accounts for 10.3% of the population of adults with one or more CSCs who did not receive PC services during a hospitalisation (unmet need). Monthly internal reporting of this metric led to significant PC programme expansion with an increase in average penetration for the six hospitals from 5.9% in 2017 to 11.2% in 2021.ConclusionsHealth system leadership can benefit from quantifying the need for specialty PC among seriously ill inpatients. This anticipated measure of unmet need is a quality indicator that complements existing metrics.
Subject
Medical–Surgical Nursing,Oncology (nursing),General Medicine,Medicine (miscellaneous)
Reference27 articles.
1. Byock I . The best care possible: A physician’s quest to transform care through the end of life. New York: Avery, 2012.
2. Association Between Palliative Care and Patient and Caregiver Outcomes
3. Early palliative care consultation in the medical ICU: a cluster randomized crossover trial;Ma;Crit Care Med,2019
4. National Quality Forum . “National voluntary consensus standards for palliative care and end-of-life care,” [online]. Available: https://www.qualityforum.org/topics/Palliative_Care_and_End-of-Life_Care.aspx [Accessed 18 Nov 2020].
5. Economic evaluation of a hospital-based palliative care program;Isenberg;J Oncol Pract,2017
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献