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Quality indicators for palliative care: a systematic review.

H Roeline W Pasman¹, Hella E Brandt, Luc Deliens

¹Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. hrw.pasman@vumc.nl

Journal of Pain and Symptom Management

|July 21, 2009

Summary

While palliative care needs are understood, quality assessment is hindered by a lack of defined indicators. This review found 142 quality indicators, but detailed specifications are needed for effective palliative care monitoring.

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Area of Science:

Palliative Care Medicine
Healthcare Quality Improvement
Health Services Research

Background:

Understanding of terminally ill patients' needs has grown, yet palliative care quality remains suboptimal.
The absence of standardized quality indicators impedes the assessment of palliative care effectiveness.
This gap necessitates a comprehensive review of existing quality indicators in palliative care.

Purpose of the Study:

To systematically review published quality indicators for palliative care across all patient groups and settings.
To assess the coverage of these indicators across all domains of palliative care.
To describe the types and methodological characteristics of identified quality indicators.

Main Methods:

Systematic review of computerized database searches up to December 2007.
Independent selection of publications detailing the development or characteristics of palliative care quality indicators.
Data extraction focused on indicator description, type, target population, setting, and defined numerators/denominators.

Main Results:

16 publications met inclusion criteria, describing eight sets of quality indicators.
A total of 142 unique quality indicators were identified, covering all but the cultural aspects domain of palliative care.
Most indicators focused on palliative care outcomes or processes, with considerable variation in methodological characteristics.

Conclusions:

A substantial number of palliative care quality indicators exist, but many lack detailed methodological descriptions.
Further development of detailed specifications is crucial for accurate monitoring of palliative care quality.
Addressing the identified gaps will enhance the systematic evaluation and improvement of palliative care services.