Hospice Care Literature Review

Pages: 5 (2278 words)  ·  Bibliography Sources: 8  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Healthcare

In an article by Isabelle Colombet et al. (2011), they examined the impact of "oncologist awareness of palliative care (PC), the intervention of the PC team (PCT) and multidisciplinary decision-making on three quality indicators of end-of-life (EOL) care" (Isabelle Colombet et al., 2011, p. xx-xx)" The results revealed PCT intervention did not improve indicators but OPM or onco-palliative meetings, did decrease the odds of patients getting chemotherapy during the last few weeks of their life. The study shows the need for multidisciplinary decision-making in PCT in order to improve EOL care. End of life care or EOL requires more than simple measures and OPMs could be an indicator of which direction to take in order to improve this area.

Some literature serves the purpose of presenting statistics. Vitas Care shows on aveage the statistics for medicare patients:

"1 in 5 Medicare patients re-admit within 30 days

1 in 3 Medicare patients re-admit within 90 days

14-17% general population re-admit within 30 days

30 day re-admissions cost Medicare $12-15 billion" (VITAS Innovative Hospice Care of Connecticut & Kinzbrunner, 2009, p. 4)

Along with this information, the report presented statistics of the Affordable Care Act (ACA):

Designed to drive meaningful reductions in all-cause readmissions by aligning payment with outcome

Outcome measure: Hospital specific, risk standardized, all cause 30-day excess readmission ratio following index hospitalizations for AMI, heart failure, or pneumonia.Get full Download Microsoft Word File access
for only $8.97.

2013: 1% reduction in Medicare base reimbursement for inpatient services for all DRGs.

2014: 2% and 2015: 3%" (VITAS Innovative Hospice Care of Connecticut & Kinzbrunner, 2009, p. 4)

Literature Review on Hospice Care Is a Kind Assignment

Goodman, Fisher, & Chang (2011), presented a report discussing the effectiveness of communities and hospitals in relation to care for seriously or terminally ill patients. They state: "Without high-quality care coordination, patients can bounce from home to the emergency room and back into the hospital, sometimes repeatedly" (Goodman, Fisher, & Chang, 2011, p. 1-9) One of the main purposes of this paper is to reduce readmission rates. Goodman, Fisher, & Changs report show ability to coordinate care for patients in all care settings such as hospitals and nursing facilities, will lead to not only improvement of quality of life, but also reduction in costs, and lesser rates of readmission. They also reveal readmission leads to enormous cost to Medicare making reduction in readmissions a priority.

Another study by Coleman, Parry, Chalmers, & Min (2006) reveals the cost benefits of fewer re-admissions along with ways to minimize re-hospitalization rates. Of the things that were mentioned: patient's assertion of preferences, tools to promote cross-site communication, and continuity seemed to yield positive results. "Intervention patients had lower rehospitalization rates at 30 days (8.3 vs. 11.9, P = .048) and at 90 days (16.7 vs. 22.5, P = .04) than control subjects. Intervention patients had lower re-hospitalization rates for the same condition that precipitated the index hospitalization at 90 days (5.3 vs. 9.8, P = .04) and at 180 days (8.6 vs. 13.9, P = .046) than controls" (Coleman, Parry, Chalmers, & Min, 2006, p. 1822-1828) Not only did the rates of re-hospitalization decrease, but the costs consequently did as well. Early palliative treatment is complex and needs a lot of planning to work.


Abel, J., Pring, A., Rich, A., Malik, T., & Verne, J. (2013). The impact of advance care planning of place of death, a hospice retrospective cohort study. BMJ Support Palliat Care, 3(2), 168-173. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632964/

Brown, R.S., Peikes, D., Peterson, G., Schore, J., & Razafindrakoto, C.M. (2012). Six Features of Medicare Coordinated Care Demonstration Programs that Cut Hospital Admissions of High-Risk Patients. Health Affairs, 31(6), 1156-1166.

Coleman, E.A., Parry, C., Chalmers, S., & Min, S. (2006). The Care Transitions Intervention: Results of a Randomized Controlled Trial. Archives of Internal Medicine, 2006(166), 1822-1828. doi:10.1001/archinte.166.17.1822

Goodman, D.C., Fisher, E.S., & Chang, C.H. (2011). After Hospitalization: A Dartmouth Atlas Report on Post-Acute Care for Medicare Beneficiaries. Retrieved from The Dartmouth Institute website: http://www.dartmouthatlas.org/downloads/reports/Post_discharge_events_092811.pdf

Isabelle Colombet1,2,3, Vincent Montheil3, Jean-Philippe Durand4, Florence Gillaizeau1,2, Ralph Niarra2, Cecile Jaeger3, Jerome Alexandre1,4, Francois Goldwasser1,4 and Pascale Vinant3, I., Montheil, V., Durand, J.P., Gillaizeau, F., Niarra, R., Jaeger, C., Alexandre, J., Goldwasser, F., & Vinant, P. (2011). Effect of integrated palliative care on the quality of end-of-life care: retrospective analysis of 521 cancer patients. BMJ Support Palliat Care. doi:10.1136/bmjspcare-2011-000157

Smith, T.J., Temin, S., Alesi, E.R., Abernathy, A.P., Balboni, T.A., Basch, E.M., Ferrell, B.R., Loscalzo, M., Meier, D.E., Paice, J.A., Peppercorn, J.M., Somerfield, M., Stovall, E., & Von Roenn, J.H. (2012). American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care into Standard Oncology Care. JOURNAL OF… [END OF PREVIEW] . . . READ MORE

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