End-of-Life Quality of Care in Nursing Homes

描述（由申请人提供）：养老院越来越多地照顾和老年人死亡的地方。然而，据报道，养老院居民在生命结束时（EOL）提供的护理质量不足。缺乏有关美国疗养院终末期护理质量的比较经验证据，并且目前没有疗养院终末期护理质量的风险调整措施。拟议的研究的目的是开发和验证个人指标和综合措施，用于评估养老院的EOL护理质量，并确定与上级EOL护理质量相关的设施的特征。该项目的具体目标是：1）开发和验证单个和复合EOL质量指标。2)检查各个指标和综合质量指标的横截面和纵向变化，例如跨州，设施所有权类型等。3）确定与更好的个人和综合质量指标相关的养老院的EOL实践模式和特征。在这项研究的过程中开发的措施，可以提供一个原型的EOL质量措施被纳入公开传播的报告卡，如医疗保险护理之家比较。从这个项目中获得的经验性见解可用于测试和实施策略，提高养老院的EOL护理质量。公共卫生相关性本项目将通过开发一个生命终了质量衡量标准的原型来改善公共卫生，该标准可纳入公开分发的报告卡，如疗养院比较。从这个项目中吸取的经验教训，可用于实施和测试战略，以提高临终关怀护理在养老院的质量。

DESCRIPTION (provided by applicant): Nursing homes are increasingly the place of care and death for older persons. However, the quality of care provided to nursing home residents at the end-of-life (EOL) has been reported to be inadequate. Comparative empirical evidence on the quality of EOL care in US nursing homes is lacking and there are currently no risk adjusted measures of EOL quality of care in nursing homes. The objective of the proposed study is to develop and validate individual indicators and a composite measure for assessing EOL quality of care in nursing homes, and to identify characteristics of facilities associated with superior EOL quality of care. The specific aims of this project are to: 1) Develop and validate individual and composite EOL indicators of quality. 2) Examine cross-sectional and longitudinal variations in individual indicators and in the composite quality measure, for example across states, facility ownership type, etc. 3) Identify EOL practice patterns and characteristics of nursing homes that are associated with better individual and composite quality measures. The measures developed in the course of this study could provide a prototype for EOL quality measures to be incorporated into publicly disseminated report cards such as the Medicare Nursing Home Compare. Empirical insights gained from this project may be used to test and implement strategies for improving the quality of EOL care in nursing homes. PUBLIC HEALTH RELEVANCE This project will improve public health by developing a prototype for end-of-life quality measures that could be incorporated into publicly disseminated report cards such as the Nursing Home Compare. Lessons learned from this project may be used to implement and test strategies for improving the quality of end-of-life care in nursing homes.