First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service

Am J Hosp Palliat Care. 2017 Mar;34(2):166-172. doi: 10.1177/1049909115617139. Epub 2016 Jul 11.

Abstract

Background: There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers.

Aim: To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District.

Methods: This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees.

Results: Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service.

Conclusion: An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.

Keywords: community hospital; hospitalizations; in-home; palliative care; partnerships; quality of life; satisfaction; visiting nurse service.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Home Care Services / organization & administration
  • Home Care Services / standards
  • Hospitals, Community / organization & administration*
  • Humans
  • Interinstitutional Relations
  • Male
  • Middle Aged
  • Models, Organizational
  • New York
  • Nurses, Community Health* / organization & administration
  • Nurses, Community Health* / standards
  • Palliative Care / organization & administration
  • Palliative Care / standards
  • Patient Satisfaction
  • Program Evaluation
  • Prospective Studies
  • Quality of Life