First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service

2016 ◽  
Vol 34 (2) ◽  
pp. 166-172 ◽  
Author(s):  
Katherine Pouliot ◽  
Carol S. Weisse ◽  
David S. Pratt ◽  
Philip DiSorbo
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Community Hospital ◽  
Hospital Admissions ◽  
Care Program ◽  
Emergency Department Visits ◽  
Care Providers ◽  
Palliative Care Program ◽  
Home Based ◽  
Visiting Nurse

Background: There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers. Aim: To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine’s community hospital serving New York’s Capital District. Methods: This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees. Results: Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service. Conclusion: An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients’ desire to remain at home and avoid hospital admissions.

Cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure

2017 ◽  
Vol 32 (2) ◽  
pp. 476-484 ◽  
Author(s):  
Frances Kam Yuet Wong ◽  
Ching So ◽  
Alina Yee Man Ng ◽  
Po-Tin Lam ◽  
Jeffrey Sheung Ching Ng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Cost Effectiveness ◽  
Care Program ◽  
Palliative Care Program ◽  
Home Based ◽  
End Stage Heart Failure ◽  
End Stage ◽  
Transitional Home

An Active In-Home Physician Model of Palliative Care and Its Resulting Performance Indicators Related to Home Deaths, Unplanned Emergency Department Visits and Unplanned Hospital Admissions

2020 ◽  
Vol 36 (1) ◽  
pp. 46-49
Author(s):  
Colleen Webber ◽  
Aurelia Ona Valiulis ◽  
Peter Tanuseputro ◽  
Valerie Schulz ◽  
Tavis Apramian ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Hospital Admissions ◽  
Case Series ◽  
Palliative Care Team ◽  
Emergency Department Visits ◽  
Care Team ◽  
Retrospective Case ◽  
Palliative Care Teams ◽  
Unplanned Hospital Admissions

Background: Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams. Case presentation: A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019. Case management: The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization. Case outcomes: In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( n = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( n = 75) patients visited an emergency department and 24.6% ( n = 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively. Conclusion: The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.

Effectiveness of a Home-Based Palliative Care Program for End-of-Life

2003 ◽  
Vol 6 (5) ◽  
pp. 715-724 ◽  
Author(s):  
Richard D. Brumley ◽  
Susan Enguidanos ◽  
David A. Cherin
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Program ◽  
Palliative Care Program ◽  
Home Based

scholarly journals Effect of a Home‐Based Palliative Care Program on Healthcare Use and Costs

2016 ◽  
Vol 64 (11) ◽  
pp. 2288-2295 ◽  
Author(s):  
J. Brian Cassel ◽  
Kathleen M. Kerr ◽  
Donna K. McClish ◽  
Nevena Skoro ◽  
Suzanne Johnson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Palliative Care Program ◽  
Healthcare Use ◽  
Home Based

scholarly journals Validation of the Spanish Version of the Quality of Dying and Death Questionnaire (QODD-ESP) in a Home-Based Cancer Palliative Care Program and Development of the QODD-ESP-12

2017 ◽  
Vol 53 (6) ◽  
pp. 1042-1049.e3 ◽  
Author(s):  
Pedro E. Pérez-Cruz ◽  
Oslando Padilla Pérez ◽  
Pilar Bonati ◽  
Oliva Thomsen Parisi ◽  
Laura Tupper Satt ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Program ◽  
Spanish Version ◽  
Palliative Care Program ◽  
Quality Of Dying ◽  
Home Based

Can Home Palliative Care services reduce Emergency Department visits? Piedmont Experience, 2013-2018

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Scacchi ◽  
P Berchialla ◽  
M Dalmasso ◽  
M M Gianino
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
Medical Care ◽  
Care Delivery ◽  
Emergency Department Visits ◽  
Care Services ◽  
Medical Care Costs ◽  
Home Based ◽  
Ed Visits ◽  
Care Costs

Abstract Background Home-based Palliative Care (HPC) ensures multi-disciplinary medical, nursing, rehabilitation and psychological assistance for people with severe disabilities or with progressive end-stage disorders like cancer, promoting the continuity of care in home setting. Emergency Department (ED) visits in palliative care patients are considered an indicator of poor quality in home care services, since ED visits in these patients are not essential and potentially avoidable. There is still no agreement in literature about the efficacy of HPC in reducing the use of ED. However, recent studies demonstrated that HPC increases patient satisfaction while reducing use of medical services like ED, symptom burden and medical costs. The objective of this study was to evaluate if patients assisted by HPC have a reduction of ED visits compared to the 90-day period before HPC admission. Methods A retrospective study using the administrative regional database of Piedmont (Italy) was conducted on the cohort of 4433 patients admitted to HPC from 2013 to 2018. ED visits during period A (90-days before HPC) and period B (during HPC) were compared for each patient, taking into account avoidable or unavoidable visits based on triage examination. Results During period A, patients had 2880 ED visits, 1934 were considered avoidable (67%). During period B, 2050 ED visits were recorded, 994 were considered avoidable (48%). Patients receiving HPC had a reduction of overall ED visits (IRR 0.87, IC 95% 0.82-0.92) as well as avoidable ED visits (IRR 0.63, IC 95% 0.58-0.67). Unavoidable ED visits increased during HPC (IRR 1.36, IC 95% 1.24-1.49), as a consequence of disease progression. Conclusions Home-based Palliative Care is associated with a significant reduction of the use of overall Emergency Department visits (-13%) and ED avoidable visits (-37%). Since it reduces medical care costs and burden of patients and caregivers at the end of life, Home-based Palliative Care delivery should be increased. Key messages Home-based Palliative Care is associated with a reduction of the use of overall Emergency Department visits and avoidable ED visits, reducing medical care costs and burden of patients and caregivers. Home-based Palliative Care delivery should be encouraged and increased, aiming to an early enrolment as well as an increase of the patients.

Impact of the caregiver burden on the effectiveness of a home-based palliative care program: A mediation analysis

2019 ◽  
Vol 18 (3) ◽  
pp. 332-338 ◽  
Author(s):  
Angela J. Pereira-Morales ◽  
Luis Enrique Valencia ◽  
Luis Rojas
Keyword(s):  
Palliative Care ◽  
Caregiver Burden ◽  
Psychological Symptoms ◽  
Care Program ◽  
Palliative Care Program ◽  
Home Based ◽  
High Prevalence ◽  
The Relationship ◽  
Significant Mediator

AbstractObjectiveThe growing aging population and the high prevalence of several concomitant chronic diseases have contributed to the elevated rates of caregiver burden and suffering in patients. In turn, intending to relieve unnecessary pain in patients, there has been a rapid growth of outpatient palliative care programs. However, little has been studied about caregiver burden as a relevant factor potentially affecting the effectiveness of these programs. This study aimed to determine the extent of caregiver burden as a possible mediator on the effectiveness of a home-based palliative care program.MethodSixty-six palliative patients (56% women; mean age + SD = 71, 6 ± 17.7) and their caregivers were assessed with measures for physical, emotional, and psychological symptoms before and 1 month after the start of a home-based palliative care program.ResultsThe association between caregiver burden and palliative outcomes was corroborated with a categorical regression model (p < 0.01). Caregiver burden was found to be a significant mediator in the relationship between outcome measures for palliative care at baseline and after 1 month of enrollment in the program.Significance of resultsTo our knowledge, this is the first study to assess the role of caregiver burden in the effectiveness of a home-based palliative care program. Although further work is required, the results indicate that a patient-focused intervention does not have the same beneficial effect if the caregiver burden is not addressed. Future home-based palliative care programs should focus on caregivers as well as patients, with particular attention to psychosocial intervention on caregivers.

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