University of Southern California, Leonard Davis School of Gerontology, Los Angeles, California.
LW Partners, New York, New York.
J Palliat Med. 2019 Oct;22(10):1274-1280. doi: 10.1089/jpm.2019.0031. Epub 2019 Jun 27.
Palliative care for seriously ill adults is spreading rapidly, giving rise to a fast-growing business sector: the home-based palliative care (HBPC) industry. These programs offer services common to most palliative care programs; what distinguishes them is that services are delivered to patients in their homes. Research shows these programs hold promise for improving patient outcomes at lower cost than usual care. Given this, growth in the HBPC business is likely fueled partly by the sector's money-making potential. As in many emerging industries, there are concerns that HBPC benefit may not be enjoyed equitably by patients and other stakeholders. To safeguard HBPC quality, we take stock of where quality problems may manifest and discuss strategies to forestall these problems. We examine HBPC trends with significant implications for care quality and cost, including HBPC payment, patient enrollment, staff management, and patient visits. Recommendations pertain to quality metrics, patient disclosures, and further research.
成人重症姑息治疗正在迅速普及，由此催生了一个快速发展的业务领域：家庭姑息治疗（HBPC）行业。这些项目提供大多数姑息治疗项目中常见的服务；使它们与众不同的是，服务是在患者家中提供的。研究表明，与常规护理相比，这些项目有望以更低的成本改善患者的预后。有鉴于此，HBPC 业务的增长可能部分是由于该行业的盈利潜力。与许多新兴行业一样，人们担心 HBPC 的利益可能无法在患者和其他利益相关者中公平享受到。为了保障 HBPC 的质量，我们评估了质量问题可能表现出来的地方，并讨论了预防这些问题的策略。我们研究了对护理质量和成本有重大影响的 HBPC 趋势，包括 HBPC 支付、患者入组、员工管理和患者就诊。建议涉及质量指标、患者披露和进一步研究。
