Palliative Care: Maximizing Patient Preference

姑息治疗：最大限度地提高患者偏好

• 批准号: 7941861
• 负责人: DONALD HUGH TAYLOR
• 金额: $ 45.24万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7941861
• 关键词: Palliative; Care; Maximizing; Patient; Preference

DESCRIPTION (Provided by Applicant): The project will develop a palliative care benefit for the Medicare program that is based on the care preferences of selected patients with metastatic cancer (non small cell lung; pancreatic; biliary; and melanoma) and their families facing the end of life. Care preferences will be elicited using the Choosing Health Plans All Together (CHAT) methodology. This approach provides patients and family members with actuarially accurate cost tradeoffs of alternatives types of health care that could be chosen. All types of care cannot be afforded, so the decision is made under a scarcity constraint. The CHAT game approach begins with individual judgment of care preferences, and proceeds to two group based decision making rounds before concluding with a final individual assessment. The CHAT approach has been used successfully with Medicare beneficiaries. We will propose a new palliative care benefit using the patient and family preferences as the primary input, and will then simulate the expected cost of such a benefit were it implemented in Medicare, and compare it to the projected costs of the current Medicare hospice benefit. The goal of the project is to develop a palliative care benefit that will increase quality of life while minimizing health care costs.

描述（由申请人提供）：该项目将根据选定的转移性癌症（非小细胞肺癌、胰腺癌、胆管癌和黑色素瘤）患者及其面临生命终结的家庭的护理偏好，为医疗保险计划开发姑息治疗福利。护理偏好将使用选择健康计划一起（CHAT）的方法。这种方法为患者和家庭成员提供了可以选择的替代医疗保健类型的精算准确的成本权衡。所有类型的护理都无法负担，因此决定是在稀缺约束下做出的。CHAT游戏方法从个人对护理偏好的判断开始，并在最后的个人评估结束之前进行两轮基于小组的决策。CHAT方法已成功地用于医疗保险受益人。我们将提出一个新的姑息治疗福利使用患者和家庭的喜好作为主要输入，然后将模拟这种福利的预期成本，如果它在医疗保险中实施，并将其与目前的医疗保险临终关怀福利的预计成本进行比较。该项目的目标是开发一种姑息治疗福利，提高生活质量，同时最大限度地减少医疗保健费用。