Quality Indicators for Home-Based Palliative Care: A Systematic Review

Area of Science:

• Palliative Care
• Health Services Research
• Quality Improvement

Background:

• Home-based palliative care (HPC) is increasingly recognized for its benefits, leading to a growing demand.
• Existing quality indicators (QIs) may not fully capture the unique aspects of HPC compared to other settings.

Purpose of the Study:

• To identify and integrate existing quality indicators (QIs) specifically for the provision of home-based palliative care (HPC).

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Medline, CINAHL, Cochrane Library, Web of Science, Embase).
• Identified QIs were categorized by structure, process, or outcome and mapped to eight care domains.
• Methodological characteristics and quality of the included studies were evaluated.

Main Results:

• Fifteen articles yielded 312 unique QIs for HPC.
• The majority of QIs focused on "Structure and Process of Care" (44.2%) and "Physical Aspects of Care" (28.8%).
• Fewer QIs addressed "Spiritual, Religious and Existential Aspects of Care" (2.2%) and "Cultural Aspects of Care" (1.6%), with variable methodological quality.

Conclusions:

• The review integrated a comprehensive set of QIs for HPC, predominantly focusing on process and outcome measures.
• There is a notable gap in QIs covering social, cultural, and spiritual dimensions of care.
• Further research is needed to develop and validate QIs for cultural sensitivity, telehealth, and patient-reported experiences to enhance HPC quality assessment.