Developing New Palliative Care Quality Indicators and Benchmarks in Cancer Across Canada
1. Temporal changes: To explore how 5 established QIs and benchmarks have changed during 2004-2015. The 5 QIs are: ED visits, ICU admission, doctor home visit, palliative homecare, and death in hospital.
Hypothesis: The 5 established QIs and benchmarks will have improved over time and in comparison to a previous analysis of the same QIs done by L. Barbera. [Barbera, L. et al. Quality Indicators of End-of-Life Care in Patients With Cancer: What Rate Is Right? Journal of Oncology Practice 2015 11:3, e279-e287]
2. InterRAI Palliative Care Quality Indicators: To apply a set of new palliative care QIs around pain and symptom management (e.g. pain, social isolation, fatigue, delirium, etc.) to our cohort. These QIs will be derived from the interRAI Home Care Assessment and from another funded CIHR project led by a co-I Dawn Guthrie. [No data acquired in BC will be used for this objective. It is being conducted at Wilfred Laurier by Dawn Guthrie].
3. How is timing of initiation of palliative care services (early vs notearly [mix of late/none]) in last year of life associated with aggressive EOL care QIs : Using propensity score matching examine aggressive EOL QIs in those who receive early palliative care services vs. those who do not receive early care (ie. late or none )
Hypothesis: Patients that receive early palliative care services will score better on aggressive EOL care QIs.