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Assessing structure, process and outcome in palliative day care: a pilot study for a multicentre trial
Hannah-Rose Douglas1, Irene J. Higginson, Kathryn Myers
1Health Services Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London,Department of Palliative Care and Policy, Guy's King's and St Thomas' School of Medicine and St Christopher's Hospice, King's College School of Medicine and Dentistry, London andPalliative Medicine, Mildmay Hospital, London.
Health & Social Care in the Community
|September 19, 2001
Summary
Palliative day care services offer core support despite varied organization. Understanding these structures is key to effective research and evaluation of patient-centered outcomes.
Area of Science:
- Health Services Research
- Palliative Care
- Social Care Evaluation
Background:
- Palliative day care services are expanding but lack sufficient research.
- Robust study designs are needed to evaluate costs and outcomes for patients, clinicians, and policymakers.
- Evaluation methods must meet rigorous standards comparable to other health and social service research.
Purpose of the Study:
- To explore the structure and processes of palliative day care.
- To identify methods for evaluating and measuring the outcomes of palliative day care services.
- To inform the design of a research strategy for a multicentre trial.
Main Methods:
- Exploratory research conducted at the start of a multicentre trial.
- In-depth observations at five palliative day care centres within one health region.
- Analysis using an organizational systems approach, considering diverse medical and social care models.
Main Results:
- All observed centres provided a core set of similar services, despite the absence of a national strategy.
- Variations in philosophy, ownership, and organization influenced service delivery and potentially costs.
- A deeper understanding of palliative day care models, outcomes, and processes was achieved.
Conclusions:
- Palliative day care services demonstrate a degree of standardization in core offerings.
- Organizational factors significantly impact service delivery and cost-effectiveness.
- The findings provide a foundation for developing a comprehensive research strategy to evaluate this integrated health and social care service.