Palliative Care and End-of-Life Care 


Estimates show that by 2030, there will be 72 million older persons in the United States, more than twice the number in 2000. As a result, the healthcare community in recent years has increasingly focused its attention on the quality and availability of palliative and end-of-life care services – both for acutely ill patients and older adults with life-limiting diseases.

Palliative and end-of-life care programs help improve care quality throughout the course of a patient’s illness. Patients that utilize palliative and end-of-life care tend to be more satisfied with their overall care and communication with providers, and they are less likely to end up in intensive care units and emergency departments.1,2,3 Furthermore, providers are increasingly referring patients to hospice care to ease suffering and better manage pain at the end of life.

Yet palliative and end-of-life care programs remain underused. Studies indicate more than one million patients each year who could have benefited from hospice care die without receiving it.

Related NQF Work

  • Care Coordination Measures
    NQF will review performance measures in the care coordination domain including measures focused on patient experience of care, health information technology (IT), transitions of care and structural measures.
     
  • MAP Post-Acute Care/Long-Term Care Workgroup
    This workgroup will provide input to the MAP Coordinating Committee on matters related to the selection and coordination of measures for post-acute care and long-term care providers, including hospices, inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities, and home healthcare.
     
  • Measuring Healthcare Quality for the Dual Eligible Beneficiary Population
    This MAP report addresses a strategic approach to performance measurement for a unique and clinically complex group. The report discusses a core set of available measures, potential modifications to existing measures, gap areas for future measure development, as well as potential applications and alignment opportunities.
     
  • Multiple Chronic Conditions Measurement Framework
    In May 2012, NQF endorsed measurement framework for individuals with multiple chronic conditions. The framework addresses the complex circumstances of these individuals, and is intended to serve as a guide for future measure development and NQF-endorsement decisions pertaining to measures that address this vulnerable population.
    Press Release | Endorsement Summary
     
  • Nursing Home Measures Project
    In March 2011, NQF endorsed 21 measures addressing care of both long-term residents and short-stay patient of nursing homes. The measures are used in the Centers for Medicare & Medicaid Services’ Nursing Home Compare, an online database for consumers to compare the care provided in more than 17,000 nursing homes across the country.
     
  • Palliative and End-of-Life Care Measures Project
    In February 2012, NQF endorsed 14 measures on palliative care and end-of-life care. The measures address a wide range of care concerns, including pain management, psychosocial needs, care transitions, and experiences of care.
    Press Release | Endorsement Summary
     
  • Performance Measurement Coordination Strategy for Hospice and Palliative Care
    This MAP report provides a strategy to enhance alignment with a focus on three key areas: 1) high-leverage measure concepts for hospice and palliative care to promote common goals across programs; 2) measures that can be readily incorporated into hospice and palliative care measurement programs; and 3) a pathway for improving measure application.

Footnotes 

1 Gade G, Venohr I, Conner D, et al., Impact of an inpatient palliative care team: a randomized controlled trial, J Palliat Med, 2008;11(2):180-190.

2 Dudgeon D, Knott C, Eichholz M, et al., Palliative Care Integration Project (PCIP) quality improvement strategy evaluation, J Pain Symptom Manage, 2008: 35(6): 573-582.

3 Morrison RS, Dietrich J, et al, Palliative care consultation teams cut hospital costs for Medicaid beneficiaries, Health Affair, March 2011; 30(3) 454-463.

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