Per-Patient Illness Trajectory Analyses

Area of Science:

• Palliative Care
• Health Services Research
• Data Visualization

Background:

• Traditional summary statistics obscure individual patient suffering in end-of-life care.
• Quality improvement efforts are hindered by the lack of individual patient perspectives in aggregated data.

Purpose of the Study:

• To present the end-of-life healthcare experience of a population while retaining individual patient details.
• To introduce a novel data display method for analyzing patient trajectories.

Main Methods:

• Developed and tested 'per-patient illness trajectory analysis' using a cohort of 192 cancer patients.
• Utilized chart reviews to gather detailed information on illness trajectory events, focusing on unplanned hospitalizations.
• Created per-patient timelines from diagnosis to death on a logarithmic scale to enhance end-of-life time resolution.

Main Results:

• The logarithmic scale effectively expands time resolution towards the end of life compared to linear scales.
• The method demonstrated feasibility and promise for analyzing populations up to 200 individuals.
• Per-patient analysis facilitates assessment of unmet palliative care needs and quality at individual and group levels.

Conclusions:

• Per-patient illness trajectory analysis is a feasible and promising method for evaluating end-of-life care.
• This approach can improve the assessment of palliative care quality and unmet needs.
• The method can be extended to larger populations through random sampling.