Abstract
Background/aims: Governments must meet the requirements of Universal Health Coverage to provide palliative care as an essential health service. It is important to ensure that measurable quality indicators underpin diverse models across international health systems, and that outcomes are demonstrated for patients and families. The study aim is to describe and evaluate models and quality indicators of palliative care across all 6 WHO regions, in terms of structure, process, and outcomes.
Methods: Design: Mixed methods longitudinal study of newly referred palliative care adult patients and their families with embedded qualitative interviews. Convenience sampling was applied. Setting: Belarus, Jamaica, Oman, Thailand, Vietnam, and Zimbabwe. Methods: Phase of illness was measured and monthly Integrated Palliative Care Outcome Scale (IPOS) and Client Services Receipt Inventory. Analysis: Comparative tabulation of service proforma; assessment of psychometric properties of outcome tool; descriptive analysis of service use; thematic analysis of qualitative interview data.
Results: N=741 patients, mean 58.6 years old, majority digestive organs cancer. Internal consistency of IPOS (Cronbach a=0.78) and test-retest reliability (canonical correlation=0.76) were confirmed. Patterns of health service use differed by country due to variation in healthcare resources and systems. From 54 qualitative interviews, 4 care domains (good physical symptom management, adequate psychological support, respecting social norm, and trusting relationship) and 5 system indicators (information provision, friendly environment, adequate funding, communication and continuous care, and shared decision-making) were identified for quality palliative care.
Conclusions: Despite vast heterogeneity in service models and samples, it is possible to identify core outcomes and measure these, and define quality cross-nationally. We support locally-led additional quality indicators to ensure contextual relevance.
Methods: Design: Mixed methods longitudinal study of newly referred palliative care adult patients and their families with embedded qualitative interviews. Convenience sampling was applied. Setting: Belarus, Jamaica, Oman, Thailand, Vietnam, and Zimbabwe. Methods: Phase of illness was measured and monthly Integrated Palliative Care Outcome Scale (IPOS) and Client Services Receipt Inventory. Analysis: Comparative tabulation of service proforma; assessment of psychometric properties of outcome tool; descriptive analysis of service use; thematic analysis of qualitative interview data.
Results: N=741 patients, mean 58.6 years old, majority digestive organs cancer. Internal consistency of IPOS (Cronbach a=0.78) and test-retest reliability (canonical correlation=0.76) were confirmed. Patterns of health service use differed by country due to variation in healthcare resources and systems. From 54 qualitative interviews, 4 care domains (good physical symptom management, adequate psychological support, respecting social norm, and trusting relationship) and 5 system indicators (information provision, friendly environment, adequate funding, communication and continuous care, and shared decision-making) were identified for quality palliative care.
Conclusions: Despite vast heterogeneity in service models and samples, it is possible to identify core outcomes and measure these, and define quality cross-nationally. We support locally-led additional quality indicators to ensure contextual relevance.
| Original language | English |
|---|---|
| Pages (from-to) | 199-199 |
| Number of pages | 1 |
| Journal | Palliative Medicine |
| Volume | 37 |
| Issue number | 1S |
| DOIs | |
| Publication status | Published - 7 Jun 2023 |
| Event | 18th EAPC World Congress - Rotterdam, Netherlands Duration: 15 Jun 2023 → 17 Jun 2023 |
