Palliative Care: Maximizing Patient Preference

描述(由申请人提供)：该项目将为医疗保险计划开发一项姑息治疗福利，该福利基于选定的转移性癌症(非小细胞肺癌、胰腺癌、胆管癌和黑色素瘤)患者及其家人面临生命终结时的护理偏好。护理偏好将使用选择所有健康计划(CHAT)方法得出。这种方法为患者和家属提供了可供选择的替代医疗保健类型的精算成本权衡。所有类型的护理都负担不起，所以这个决定是在稀缺性限制下做出的。聊天游戏方法从个人对护理偏好的判断开始，然后进行两轮基于群体的决策，然后以最终的个人评估结束。Chat方法已成功地用于医疗保险受益人。我们将提出一种新的姑息治疗福利，将患者和家庭的偏好作为主要输入，然后模拟这种福利在联邦医疗保险中实施的预期成本，并将其与当前联邦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，在提高生活质量的同时将医疗成本降至最低。

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.