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Study recommends ways to evaluate end-of-life care in nursing homes
Date:4/16/2012

re and subsequent steps taken by providers be that a nursing home or a hospital to improve care."

The study's authors looked at two quality measures: the number of dying residents who were transferred to a hospital and subsequently died there and the use of hospice care in nursing homes. Their goal was to create prototypes of quality measures for end of life care and to demonstrate that such measures could be calculated from information that is currently available and added to the Nursing Home Compare report card.

Fewer hospital transfers particularly at the end of life are considered to indicate a higher level of care in a nursing home. Previous studies have shown that 45 percent of the time such transfers are inappropriate and avoidable. Because transfers increase the risk of illness, heighten stress, and are disruptive, they can accelerate a person's decline in health and quality of life. The study found that 20 percent of long-term nursing home residents died in a hospital.

The use of hospice care in which specialists in areas of pain and symptom management and psychological, emotional, and spiritual support and counseling are brought in to treat dying residents also indicates a higher level of end of life care quality. Currently, an estimated 33 percent of nursing home residents received hospice care at the time of their death.

The authors are also studying two other quality measures that could signal the quality of end of life care pain management and shortness of breath. The results of this study are expected to be published in another forthcoming paper.

"We believe that these measures, which can be readily calculated from data already being collected, have the potential to measure the quality of end of life care in nursing homes," said Mukamel. "This is the first attempt to identify such a measure and we hope that this leads to a long overdue discussion in the health care community regarding this
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Contact: Mark Michaud
mark_michaud@urmc.rochester.edu
585-273-4790
University of Rochester Medical Center
Source:Eurekalert

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