Palliative Care, University of Teesside, Middlesbrough, UK.
Palliat Med. 2010 Jul;24(5):544-7. doi: 10.1177/0269216310368579. Epub 2010 May 25.
The Department of Health as part of its End of Life Care Strategy has developed a set of markers as a quality of care proxy for adults at the end of life. 'The number/proportion of patients dying with the Liverpool Care Pathway (or equivalent) in place' is suggested as a quality metric for all care providers. A retrospective audit of uptake of use of the Liverpool Care Pathway (LCP) in an NHS hospital in the North of England showed that 39% of all patients who died had been placed on the LCP. Overall 58% of patients who died were judged to meet the criteria for LCP use. This represented 81% of patients dying with cancer as a primary cause compared to 51% of patients dying with non-cancer. This difference was statistically very significant. In the Trust under study, 67% of dying patients who fulfilled the LCP criteria were placed on the pathway. The results of this study suggest that a simple percentage of deaths on the pathway is an unsophisticated statistic which needs to be interpreted with care. In particular it will be influenced by the proportion of people dying with cancer or non-cancer. This should be considered particularly when presenting the results to the public and to healthcare stakeholders or when making comparisons between provider organizations.
卫生部作为其生命末期关怀策略的一部分，已经制定了一系列标志，作为生命末期成年人护理质量的代理指标。“在所有护理提供者中，建议将使用利物浦关怀路径（或同等路径）的患者数量/比例作为质量指标。”对英格兰北部一家 NHS 医院使用利物浦关怀路径（LCP）的回顾性审计显示，所有死亡患者中有 39%被安置在 LCP 上。总体而言，58%的死亡患者被认为符合 LCP 使用标准。这代表了作为主要原因死亡的癌症患者的 81%，而死于非癌症的患者为 51%。这一差异具有统计学意义。在所研究的信托中，67%符合 LCP 标准的临终患者被安置在该路径上。这项研究的结果表明，单纯的路径上的死亡百分比是一种不够复杂的统计数据，需要谨慎解释。特别是，它将受到癌症或非癌症患者死亡比例的影响。在向公众和医疗保健利益相关者展示结果或在提供者组织之间进行比较时，应特别考虑这一点。
