A MULTIDIMENSIONAL HEALTH CARE INTERVENTION APPRAISAL- THE CO-ORDINATED PALLIATIVE CARE NETWORK "QUIETUDE".

Author(s)

Jasso Mosqueda JG1, Diez F2, Chen-Li-Kwang N1, Chippeaux S2, Lacour F2, Lassaunière JM3, Vinant P4, Chicoye A1, 1Annie Chicoye Economics, Neuilly sur Seine, France; 2Réseau Quiétude, Paris, France; 3Hôpital de l'Hôtel Dieu, Paris, France; 4Hôpital Cochin, Paris, France

A Health care program involves many dimensions, and its appraisal requires multicriteria decision analysis. This applies to new organisations for Health care delivery set up in France as "co-ordinated networks". Their objectives are to combine health and social care interventions in a structured framework, in hospital and outpatient settings in order to optimise Health care services. The Health care network "Quietude" was set in Paris for out-patient palliative care: to permit termination phase patients to die at home, to optimise symptoms care and hospitalisation, and to keep patients' families informed about care, medications, and administrative procedures. OBJECTIVE: To evaluate several dimensions of the "Quietude" network, medical care, organisation, patients, professionals and families satisfaction, and economic impact. METHODS: Qualitative and quantitative studies were based on interviews, questionnaires, Delphi panels, and data currently collected through the network ITS (N patient s= 435). RESULTS: Mean LOS is 40 days, and mean Health care cost per day is €190. Ambulatory care represents 80%, medication 15.5% and coordination 4.5%. Quality of care is considered as satisfactory by 94% of families and professionals. Over 95% of the professionals think pain and symptoms treatments are completely managed compared to 80% of families. Other discrepancies in perception are observed in emergency management, (92% vs 68%), hospitalisation planning (92% vs 75%), continuity of care (95% vs 80%), and administrative information access (79% Vs 70%). A total of 75% of professionals think patients' wishes for the location of their death were respected. Needs for improving population targeting and ITS were identified. CONCLUSIONS: Most objectives set by "Quietude" with regard to the Health care resources commonly employed during the last months of life were achieved to the benefit of patients, professionals, and families at a very low coordination cost. Multicriteria analysis is particularly adapted to an appraisal of this type of innovative Health care provision.

Conference/Value in Health Info

2003-11, ISPOR Europe 2003, Barcelona, Spain

Value in Health, Vol. 6, No. 6 (November/December 2003)

Code

PHP36

Topic

Health Policy & Regulatory, Health Service Delivery & Process of Care

Topic Subcategory

Health Disparities & Equity, Hospital and Clinical Practices, Quality of Care Measurement, Treatment Patterns and Guidelines

Disease

Oncology

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