Promoting palliative care access to persons with cancer: A model for mapping statewide services.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 127-127
Author(s):  
Constance Dahlin ◽  
Joshua Nyambose ◽  
Gail Merriam ◽  
Cherline Gene
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Long Term Care ◽  
Home Health ◽  
Term Care ◽  
Care Access ◽  
Care Services ◽  
Health Agencies ◽  
Palliative Care Services

127 Background: The CDC comprehensive cancer initiatives value comprehensive quality care within its mission and program development. Currently, over 75% of hospitals in the United States have palliative care services for cancer patients (CAPC 2011). In order to promote access to quality palliative care in the community outside the hospital, an evaluation is essential. The CDC model of comprehensive cancer care and prevention control structure is an appropriate mechanism to perform such an evaluation. From 2014-2015, the Massachusetts Comprehensive Cancer and Prevention Control Network Palliative Care Workgroup performed a survey to hospitals, home health agencies, hospices, long term care facilities, and community providers to determine palliative care services available to cancer patients across the state. Methods: Using the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines, a robust palliative survey tool was created by the Massachusetts Comprehensive Cancer and Prevention Control Palliative Care Workgroup. It was individualized to each of the following settings - hospitals, home health organizations, hospices, skilled nursing facilities, and community health agencies. Follow-up telephonic key informant interviews regarding palliative care services were conducted within the various settings, service organizations, and insurers. Results: The results of qualitative and quantitative data will be concluded in August. Initial results reveal significant disparities in access to palliative care across by geography and setting of care. Hospices and hospitals had the most access to palliative care services. Long term care settings and community health settings had the least access. Conclusions: Data reveals disparities in palliative care access within Massachusetts by geography, race, and setting of cancer care. This data will serve as the basis of regional networks to promote better access to palliative care for cancer patients across all settings. It is hoped this evaluation process will serve as a model for other states to perform a similar evaluation.

Access to long-term care: perceptions and experiences of older Dutch people

2015 ◽  
Vol 16 (2) ◽  
pp. 83-93 ◽  
Author(s):  
Lisette Schipper ◽  
Katrien G. Luijkx ◽  
Bert R. Meijboom ◽  
René Schalk ◽  
Jos M.G.A. Schols
Keyword(s):  
Older People ◽  
Long Term Care ◽  
Term Care ◽  
Content Type ◽  
Care Access ◽  
Care Services ◽  
Significant Difference ◽  
Access Service ◽  
The Difference

Purpose – Despite the current focus on demand-based care, little is known about what clients consider important when they have a request for formal long-term care services. The paper aims to discuss this issue. Design/methodology/approach – Questions about the access process to care services were added to the “Senior Barometer”, a Dutch web-based questionnaire that assesses the opinion of older people about different aspects in life. The questionnaire surveyed both people who already requested care services (“users”), and people that did not (“future clients”). Findings – The results show a significant difference in what people expect to be the first step from what users actually did, when requesting formal care services. In addition, there was a significant difference on how “users” and “future clients” rated several access service aspects. Research limitations/implications – The results give valuable information on how both “users” and “future clients” value the access process. The findings also provide valuable input for organizations providing long-term care for older clients about the important issues that have to be considered when organizing the access process. Originality/value – This study shows what older people in the Netherlands find important during the access process to care and this has not been explored before. The difference between what “users” and “future clients” find of importance in the care access process suggests that it is difficult for people to foresee what will be important once the need for care arrives, or where they will turn to with a request for care services.

scholarly journals Analytical study of short- and long-term results of home-based palliative care services to cancer patients

2017 ◽  
Vol 23 (3) ◽  
pp. 331
Author(s):  
Dhritiman Datta ◽  
Gautam Majumdar ◽  
Shiromani Debbarma ◽  
Badan Janapati ◽  
AmitKumar Datta
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Analytical Study ◽  
Long Term Results ◽  
Care Services ◽  
Home Based ◽  
Palliative Care Services ◽  
Short And Long Term

Abstract WP363: Trends and Disparities in Utilization of Palliative Care for Ischemic Stroke Patients Undergoing Thrombolytic Therapies: 10-Year Analysis of Nationwide Data

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kristie Chu ◽  
Erica Jones ◽  
Arvind B Bambhroliya ◽  
Jennifer R Meeks ◽  
Farhaan Vahidy
Keyword(s):  
Palliative Care ◽  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Long Term Care ◽  
Home Health ◽  
Term Care ◽  
Treatment Type ◽  
Comorbidity Burden ◽  
Iv Tpa

Introduction: We characterize 10-year nationwide trends in utilization of palliative care (PC) for ischemic stroke (IS) patients and describe in-hospital outcomes and costs for IS patients receiving PC, particularly those with acute thrombolytic therapy (TT) i.e. IV tPA and endovascular thrombectomy (EVT). Methods: We analyzed the National Inpatient Sample (90% US hospitalizations) from 2006 - 2015 and identified adult (age ≥18) IS patients, with or without TT and PC using validated ICD-9 codes. We used survey design methods to report nationally representative adjusted odds ratios (aOR) of PC utilization across five 2-year time periods. Results: Of 4,249,201 IS encounters, 4% were coded for PC utilization. PC utilization increased over time (aOR 4.80, 95% CI 4.15 - 5.55), regardless of acute treatment type (Figure 1a). Advanced age, female sex, White race, non-Medicare insurance, higher income, disease severity and comorbidity burden, and discharge from teaching hospitals in non-Northeastern regions were independently associated with receiving PC. In the fully adjusted model, treatment with IV tPA and EVT respectively confer a 5% and 10% greater likelihood of receiving PC. Overall, PC utilization is associated with higher mortality (aOR 15.14, 95% CI 14.36 - 15.96). However, 10-year outcome trends demonstrate a significant decline in in-hospital mortality compared to all other dispositions (aOR 0.46, 95% CI 0.38 - 0.56) with an increasing proportion of PC patients receiving long-term care and home health/hospice (aOR 2.42, 95% CI 2.03 - 2.88) (Figure 1b). Despite longer length of stay, PC hospitalizations incurred 16% lower adjusted costs. Conclusions: Though PC utilization has increased in IS patients, considerable disparities exist. Acute TT is associated with higher PC utilization and outcome trends indicate lower in-hospital mortality with higher long-term care and home health/hospice. Protocolized PC for IS patients may optimize outcomes and costs.

scholarly journals A Comparison of Home Health Care Between Finland and South Korea in Long-Term Care Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 82-82
Author(s):  
Jihyun Park ◽  
Suhyun Kim
Keyword(s):  
Health Care ◽  
Home Care ◽  
Registered Nurses ◽  
Home Health Care ◽  
Long Term Care ◽  
Home Health ◽  
Term Care ◽  
Care Services ◽  
Expert Interview

Abstract Population aging is one of the significant global issues. Long-term care is emphasized as “aging in place,” and it is known that home and community-based service is a cost-effective way to achieve this. Over ten years have passed since the introduction of long-term care insurance in Korea, and it is necessary to improve home health care in long-term care. The aim of this study was to identify the measures that must be undertaken for enhancing home health care in Korea by comparing it to the home health care in Finland. The data were collected via a literature review, expert interview, and field survey in Kuopio, Eastern Finland, from March 16 to 23, 2018. Based on the comparison between Korean and Finnish home health care, some issues related to home health care in Korea that need to be resolved were identified: the complex process involved in availing home health care, low utilization rate, higher cost than home health aide services in long-term care, and undifferentiated roles in home health care between registered nurses and nurse assistants. Several strategies could be utilized to enhance home health care in Korea, such as a simplified procedure to use home health care, clarification of roles between registered nurses and nurse assistants in home care, supervision of the integration of home care services by registered nurses, and an expansion of home health care into comprehensive assessment and nursing activities for chronic illness care and health promotion.

scholarly journals Grey systems in the management of demand for palliative care services in Poland

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Sylwia Nieszporska
Keyword(s):  
Palliative Care ◽  
Health Systems ◽  
Health Care Services ◽  
Long Term Care ◽  
Health Condition ◽  
Term Care ◽  
Care Services ◽  
Number Of Patients ◽  
Care Facilities

Abstract Background The concept of care for people in a critical or even terminal health condition, who are in the last stage of their life, has become the mission of palliative care facilities. Therefore, the life of a sick patient poses a number of challenges for health care services to make sure that medical services are tailored to the trajectory of the disease, as well as the various needs, preferences and resources of patients and their families. Methods Health systems financed from public funds need to adopt new methods of management to meet the high and arising demand for a long-term care. There are several ways of assessing the demand for long-term care services. The method recommended by the author and presented in more detail in this paper is the one relying on grey systems, which enables the estimation of forecasting models and, finally, actual forecasts of the number of potential future patients. Results GST can be used to make predictions about the future behaviour of the system, which is why this article aims to present the possibility of using the first-order grey model GM (1,1) in predicting the number of patients of palliative care facilities in Poland. The analysis covers the data from 2014 to 2019, whereas the prediction of the number of patients has been additionally formulated for 2020. Conclusions Health systems, particularly publicly funded ones, are characterised by a certain kind of incompleteness and uncertainty of data on the structure and behaviour of its individual components (e.g. potential patients or payers). The present study aims to prove how simple and effective grey systems models are in the decision-making process.

scholarly journals The relationship between family and residential settings: Aging in place vs long term care facility in South Korea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 622-622
Author(s):  
Joohong Min ◽  
Seung-eun Oh ◽  
Bon Kim
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Long Term Care ◽  
Family Members ◽  
Institutional Care ◽  
Home Health ◽  
Term Care ◽  
Care Services ◽  
Physical Burden

Abstract Objective This study aims to explore the factors influencing long-term-care beneficiaries’ decisions between home health care and institutional care in South Korea. This study further investigated the association between these two types of long-term care services and emotional, financial, and physical burden alleviation among the beneficiaries and their family members. Methods We analyzed data from 2019 Long-Term Care Survey. Out of 5,606 respondents, 4,079 long-term care beneficiaries and family members were included in this study. Logistic regression models were conducted to understand factors associated with types of long-term care services, and the association between types of long-term care services and burden alleviation. Results Having a spouse, having children, or a shorter geographic distance between the beneficiaries and their family members were factors associated with higher likelihood of receiving home health care rather than institutional care. Also, more sever mobility limitation, outpatient care, and fall experiences were associated with higher likelihood of receiving institutional care. Utilization of institutional care was significantly associated with higher alleviation of physical burden. No significant differences between home health care and institutional care were found on emotional and financial burden alleviation. Conclusions The findings suggest that family resources may be beneficial for older adults to pursue aging in place in later life. However, the physical toll of their family members may exist. Our findings provide evidence to inform public policy decisions on long-term care services for older adults and their family members.

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