JAMA Publishes Study Examining End-of-Life Care in U.S. Highest Levels of Satisfaction Provided by Hospice Care at Home (1/06/04)
To: NHPCO Membership
JAMA Publishes Study Examining End-of-Life Care in U.S. Highest Levels of Satisfaction Provided by Hospice Care at Home
Alexandria, VA – Dying Americans receive inadequate pain management, little emotional support, and poor communication from their physicians according to a study released in the January 7, 2004 issue of the Journal of the American Medical Association. This is particularly true for those dying in institutional settings, according to researchers at Brown University. Hospice care at home provided greater levels of satisfaction and fewer problems with pain management according to this national study examining family perspectives on care at the end of life.
Home-based hospice care received the highest levels of overall satisfaction from respondents. More than 70 percent of family members of patients who received hospice care at home rated care as “excellent.” The authors reported that “bereaved family mem-bers of patients with home hospice services (in contrast to the other settings of care) re-ported higher satisfaction, fewer concerns with care, and fewer unmet needs.”
The study stated that “high-quality end-of-life results when health care profes-sionals (1) ensure desired physical comfort and emotional support, (2) promote shared decision making, (3) treat the dying person with respect, (4) provide information and emotional support to family members, and (5) coordinate care across settings.” These characteristics of quality end-of-life care are integral to the interdisciplinary hospice phi-losophy of care points out the National Hospice and Palliative Care Organization. Among the suggested actions for improving care was a call for expanded use of hospice, both in homes and in other settings.
“While improvements have been made in the care of the dying, the
results of this survey attest to the continued need to improve the quality
of care for seriously ill and dy-ing persons,” says lead author Joan Teno,
M.D., a professor of Community Health and Medicine at the Brown Medical
Key findings from the report include:
NHPCO has been actively collaborating with Teno and her colleagues at
Brown University and has adopted part of the survey used in this important
study in the creation of their Family Evaluation of Hospice Care survey
program. This research tool, launched in 2003, is used by NHPCO
member hospice programs to gather critical feedback from families
served. NHPCO has been working with hospice providers to measure
family satisfaction for ten years. However, this new survey tool
provides more information, benchmarking data, and greater opportunities to
Additional information on the study, including narrative quotes from respondents, is available at www.chcr.brown.edu/dying/factsondying2004.htm.
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