Using Routinely Collected Data to Ascertain Concordance With Advance Care Planning Preferences

Area of Science:

• Health Services Research
• Public Health
• Gerontology

Background:

• Assessing the alignment between patient preferences and care received is crucial for evaluating advance care planning effectiveness.
• Routinely collected health care data offer a potential avenue for large-scale outcome assessment in national programs.

Purpose of the Study:

• To determine the feasibility of using administrative health data to evaluate advance care planning outcomes.
• To measure the concordance between patients' stated goals and preferences and the care they actually received.

Main Methods:

• A retrospective cohort study utilizing administrative data, including hospital procedural and diagnosis-related codes, health service utilization, and death registry data.
• Medical treatments, places of care, and place of death were extracted from administrative records.
• These data were compared against individual advance care planning preferences to assess concordance.

Main Results:

• The study included 1731 decedents aged 21 years and above who had completed advance care planning documentation.
• Ninety-eight percent of individuals desiring comfort measures received them.
• Concordance varied for other preferences: 65% received home care when desired, and 40% achieved home death wishes.

Conclusions:

• Administrative data provide a cost-efficient method for evaluating large, population-based national advance care planning programs.
• While promising, this approach requires further validation before widespread implementation for outcome assessment.