End-of-Life Quality of Care in Nursing Homes

描述（由申请人提供）：养老院越来越多地成为老年人照顾和死亡的地方。然而，护理质量提供给养老院居民在生命终结（EOL）已被报道是不足的。美国养老院EOL护理质量的比较经验证据缺乏，目前没有养老院EOL护理质量的风险调整措施。本研究的目的是发展并验证个别指标和综合措施，以评估养老院的EOL护理质量，并确定与优质EOL护理质量相关的设施特征。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)检查个体指标和综合质量测量的横截面和纵向变化，例如跨州、设施所有权类型等。3)确定与更好的个体和综合质量测量相关的养老院EOL实践模式和特征。在本研究过程中制定的措施可以为EOL质量措施提供一个原型，以纳入公开传播的报告卡，如医疗保险养老院比较。从这个项目中获得的经验见解可以用来测试和实施改善养老院EOL护理质量的策略。与公共卫生的关系该项目将通过制定可纳入养老院比较等公开分发的报告卡的临终质量措施的原型来改善公共卫生。从这个项目中吸取的经验教训可以用来实施和测试提高养老院临终关怀质量的策略。

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.