Study: Quality measures are needed for end-of-life care

As the number of people who choose nursing homes for end-of-life care continues to rise, more quality measures are needed to help consumers judge performance, a new study recommends.

The Centers for Medicare & Medicaid Services currently uses two quality measures for evaluating end-of-life care. They are the number of dying residents who were transferred to a hospital and subsequently died there, and the use of hospice care in nursing homes.

Investigators say they would like to see two new measures added to CMS’ list: assessing the level of a resident’s pain and determining if there is shortness of breath. Nurses are expected to play a key role in these assessments.

By 2020, 40% of Americans are expected to be receiving end-of-life care in a nursing home. But experts assert that while there is increased adoption of healthcare facility “report cards,” none of them adequately reflects which facilities provide the best care in this area. They say this lack of information prevents potential residents and families from making informed choices.

“We know that there is a correlation between the publishing of quality measures and subsequent steps taken by providers — be that a nursing home or a hospital — to improve care,” said Dana B. Mukamel, Ph.D., a professor in the Department of Medicine and senior fellow with the Health Policy Research Institute at the University of California-Irvine.

The study was in the Journal of Palliative Medicine.