Cargando…
Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease
BACKGROUND/AIMS: We examined the quality of palliative care received by patients with decompensated cirrhosis using an explicit set of palliative care quality indicators (QIs) for patients with end-stage liver disease (PC-ESLD). METHODS: We identified patients newly diagnosed with decompensated cirr...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223418/ https://www.ncbi.nlm.nih.gov/pubmed/31927765 http://dx.doi.org/10.1007/s10620-019-05983-y |
_version_ | 1783533747676643328 |
---|---|
author | Patel, Arpan Asch, Steven Antonio, Anna Liza Kanwal, Fasiha Lorenz, Karl Riopelle, Deborah Dickey, Anna Larkin, Jennifer Lee, Martin Walling, Anne |
author_facet | Patel, Arpan Asch, Steven Antonio, Anna Liza Kanwal, Fasiha Lorenz, Karl Riopelle, Deborah Dickey, Anna Larkin, Jennifer Lee, Martin Walling, Anne |
author_sort | Patel, Arpan |
collection | PubMed |
description | BACKGROUND/AIMS: We examined the quality of palliative care received by patients with decompensated cirrhosis using an explicit set of palliative care quality indicators (QIs) for patients with end-stage liver disease (PC-ESLD). METHODS: We identified patients newly diagnosed with decompensated cirrhosis at a single veterans health center and followed up them for 2 years or until death. We piloted measurement of PC-ESLD QIs in all patients confirmed to have ESLD using a chart abstraction tool. RESULTS: Out of 167 patients identified using at least one sampling strategy, 62 were confirmed to meet ESLD criteria with chart abstraction. Ninety-eight percent of veterans in the cohort were male, mean age at diagnosis was 61 years, and 74% were White. The overall QI pass rate was 68% (64% for information care planning QIs and 76% for supportive care QIs). Patients receiving specialty palliative care consultation were more likely to receive information care planning QIs (67% vs. 37%, p = 0.02). The best performing sampling strategy had a sensitivity of 62% and specificity of 60%. CONCLUSION: Measuring the quality of palliative care for patients with ESLD is feasible in the veteran population. Our single-center data suggest that the quality of palliative care is inadequate in the veteran population with ESLD, though patients offered specialty palliative care consultation and those affected by homelessness, drug, and alcohol abuse may receive better care. Our combination of ICD-9 codes can be used to identify a cohort of patients with ESLD, though better sensitivity and specificity may be needed. |
format | Online Article Text |
id | pubmed-7223418 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-72234182020-05-15 Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease Patel, Arpan Asch, Steven Antonio, Anna Liza Kanwal, Fasiha Lorenz, Karl Riopelle, Deborah Dickey, Anna Larkin, Jennifer Lee, Martin Walling, Anne Dig Dis Sci Original Article BACKGROUND/AIMS: We examined the quality of palliative care received by patients with decompensated cirrhosis using an explicit set of palliative care quality indicators (QIs) for patients with end-stage liver disease (PC-ESLD). METHODS: We identified patients newly diagnosed with decompensated cirrhosis at a single veterans health center and followed up them for 2 years or until death. We piloted measurement of PC-ESLD QIs in all patients confirmed to have ESLD using a chart abstraction tool. RESULTS: Out of 167 patients identified using at least one sampling strategy, 62 were confirmed to meet ESLD criteria with chart abstraction. Ninety-eight percent of veterans in the cohort were male, mean age at diagnosis was 61 years, and 74% were White. The overall QI pass rate was 68% (64% for information care planning QIs and 76% for supportive care QIs). Patients receiving specialty palliative care consultation were more likely to receive information care planning QIs (67% vs. 37%, p = 0.02). The best performing sampling strategy had a sensitivity of 62% and specificity of 60%. CONCLUSION: Measuring the quality of palliative care for patients with ESLD is feasible in the veteran population. Our single-center data suggest that the quality of palliative care is inadequate in the veteran population with ESLD, though patients offered specialty palliative care consultation and those affected by homelessness, drug, and alcohol abuse may receive better care. Our combination of ICD-9 codes can be used to identify a cohort of patients with ESLD, though better sensitivity and specificity may be needed. Springer US 2020-01-11 2020 /pmc/articles/PMC7223418/ /pubmed/31927765 http://dx.doi.org/10.1007/s10620-019-05983-y Text en © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2020 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article Patel, Arpan Asch, Steven Antonio, Anna Liza Kanwal, Fasiha Lorenz, Karl Riopelle, Deborah Dickey, Anna Larkin, Jennifer Lee, Martin Walling, Anne Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title | Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title_full | Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title_fullStr | Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title_full_unstemmed | Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title_short | Measuring the Quality of Palliative Care for Patients with End-Stage Liver Disease |
title_sort | measuring the quality of palliative care for patients with end-stage liver disease |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223418/ https://www.ncbi.nlm.nih.gov/pubmed/31927765 http://dx.doi.org/10.1007/s10620-019-05983-y |
work_keys_str_mv | AT patelarpan measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT aschsteven measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT antonioannaliza measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT kanwalfasiha measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT lorenzkarl measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT riopelledeborah measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT dickeyanna measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT larkinjennifer measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT leemartin measuringthequalityofpalliativecareforpatientswithendstageliverdisease AT wallinganne measuringthequalityofpalliativecareforpatientswithendstageliverdisease |