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Palliative care quality indicators in Italy. What do we evaluate?
Daniela D'Angelo1, Chiara Mastroianni, Ercole Vellone
1School of Nursing, University Tor Vergata, Rome, Italy. d.angelo@med.uniroma2.it
Summary
Italian palliative care quality indicators are heavily focused on structure and process, but lack outcome measures. Future efforts should develop indicators addressing spiritual, ethical, and existential domains for comprehensive end-of-life care evaluation.
Area of Science:
- Palliative Care Medicine
- Health Services Research
- Quality Improvement
Background:
- The expansion of palliative care services necessitates robust evaluation methods.
- Policymakers and program managers require effective criteria for assessing end-of-life care quality.
- Quality measurement is challenging, requiring focus on relevant indicators.
Purpose of the Study:
- To provide an overview of palliative care indicators developed by Italian national authorities.
- To evaluate the comprehensiveness of existing Italian palliative care quality indicators.
Main Methods:
- Analysis of all palliative care indicators from Italian national authorities (2000-present).
- Categorization of indicators into structure, process, and outcome levels.
- Independent review and expert panel consensus on indicator concordance with established guidelines.
Main Results:
- Most analyzed indicators focus on the structure and process of palliative care delivery.
- A significant gap exists in outcome indicators within the current Italian framework.
- Spiritual, ethical, cultural, and existential aspects of care are inadequately covered by existing indicators.
Conclusions:
- There is a critical need to develop more outcome-oriented palliative care indicators.
- Future development should aim for indicators that encompass all domains of palliative care, including subjective experiences.
- New cognitive models are needed to address the complexity of measuring subjective aspects of care.
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