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Palliative care quality measures: an exploratory study
  1. Alessandra Buja1,
  2. Michele Rivera1,
  3. Vincenzo Baldo1,
  4. Marta Soattin2,
  5. Ylenia Rizzolo3,
  6. Giuseppe Zamengo3,
  7. Sarah Boscolo3,
  8. Maria Cristina Ghiotto3 and
  9. Gianfranco Damiani4,5
  1. 1 Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, Laboratory of Health Care Services and Health Promotion Evaluation, Hygiene and Public Health Unit, University of Padova, Padova, Italy
  2. 2 School of Hygiene and Preventive Medicine, University of Padova, Padova, Italy
  3. 3 Primary Care and Territorial Social-Health Structures Area – Veneto Region, Venezia, Italy
  4. 4 Fondazione Policlinico Universitario A. Gemelli IRCCS, Igiene ospedaliera, Roma, Italy
  5. 5 Università Cattolica del Sacro Cuore, Istituto di Sanità Pubblica, Roma, Italy
  1. Correspondence to Dr Alessandra Buja, Department of Cardiologic, Vascular and Thoracic Sciences, and Public Health, Laboratory of Health Care Services and Health Promotion Evaluation, Hygiene and Public Health Unit, University of Padova, Padova 35131, Italy; alessandra.buja{at}unipd.it

Abstract

Objectives The aim of this study was to investigate how palliative care service structures and processes correlate with their outputs and outcomes, measuring the latter respectively in terms of intensity of care and death at home.

Methods The Veneto Regional Health Authorities collected a set of 37 quality indicators for the year 2016, covering the following five dimensions: service integration, service structure, accessibility, professional processes and organisational processes. Their validity was assessed by a panel of 29 palliative care experts. A score was assigned to each indicator on the basis of its relevance. Non-parametric correlations between the care quality indicators and the measures of the palliative care outputs and outcomes were investigated, along with the presence of a monotonic trend in the performance of the local health units (LHU) grouped by ‘low’, ‘medium’ or ‘high’ scores and differences between these groups of LHUs.

Results The data showed that palliative care service structure and professional processes were the dimensions correlating significantly with the intensity of care coefficient. An increasingly significant statistical trend was found in both the intensity of care coefficient and the proportion of deaths at home for the three groups of LHUs in terms of the professional processes dimension.

Conclusions Despite its limitations, this study brought to light some statistically significant findings that are worth investigating in larger samples. To achieve improvements in the quality of palliative care, it is important for healthcare providers to know which variables most affect the output and especially the outcomes of the services offered.

  • healthcare
  • palliative care
  • quality management

http://dx.doi.org/10.1136/bmjspcare-2018-001679

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    Footnotes

    • Contributors AB: study conceptualisation, design and supervision; drafting and approval of final manuscript as submitted. MR: formal analysis, drafting and revision of manuscript, and approval of final version as submitted. VB: study conceptualisation, revision of the manuscript and approval of the final version as submitted. MS: drafting of the manuscript and approval of the final version as submitted. YR: study conceptualisation and supervision, critical revision of the manuscript and approval of final version as submitted. GZ: study conceptualisation and supervision, data collection, critical revision of the manuscript and approval of final version as submitted. SB: study conceptualisation and supervision, critical revision of the manuscript and approval of final version as submitted. MCG: study conceptualisation and supervision, critical revision of manuscript and approval of final version as submitted. GD: study conceptualisation, literature review, critical revision of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.