A population-level evaluation of the quality of end-of-life care

last updated 06-07-2016

Development and evaluation of quality indicators of end-of-life care and map healthcare costs in Belgium

 
Domain: Quality indicatorsPlace of Care and Place of Death
Period: 04-2014 to 03-2018
Status: 
Current

Background

Care often tends to focus on cure and life-prolonging treatments until the very last stages of life, even when these are no longer warranted or beneficial. This ‘aggressiveness’ of end-of-life care impacts on the quality and costs in the last phase of life. Until now, no robust population-level evaluation of the quality and costs of end-of-life care exists outside of North America. As collecting population-level data (across settings and types of care) would be an immense and costly effort, the challenge lies in making an efficient use of administratively collected data.

Aims

Using high quality full-population health care claims and cancer registry data in Belgium we will address three research aims:

1) to develop a comprehensive and valid set of quality indicators of end-of-life care in cancer, COPD, and dementia and calculate them at a population level
2) to map the direct healthcare costs of end-of-life care at a population level in these illnesses
3) to evaluate the influence of primary care and palliative care services on the quality and costs of end-of-life care

Methods

A combination of evidence and stakeholder consensus will be used to develop quality indicators. Administrative full-population healthcare claims and cancer registry data will be used to calculate the quality indicators and the costs. A retrospective cohort design with a propensity score matching method (which is essential in order to compare comparable patients in different settings of the health care system) will be used to evaluate the influence of primary care and palliative care.

Project group

Researcher: Robrecht De Schreye
Promotor: Joachim Cohen
Project group member: Luc Deliens
Senior researcher: Dirk Houttekier

Funding: 

FWO - Research Foundation - Flanders