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Centre for Policy on Ageing | |
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Advance care planning in a frail older population
— patient versus program influences | | Author(s) | Helena Temkin-Greener, Diane L Gross, Dana B Mukamel |
| Journal title | Research on Aging, vol 27, no 6, November 2005 |
| Pages | pp 659-691 |
| Source | http://www.sagepub.com |
| Keywords | Medical care ; Terminal care ; Management [care] ; Rights [elderly] ; United States of America. |
| Annotation | The process of advance care planning in managed care programmes serving frail older people is examined, and the contributions of individual versus programme characteristics is assessed. Data about 3,548 participants from nine PACE (Program of All-inclusive Care for the Elderly) programmes were obtained. Logistic regressions examine associations between independent variables and end-of-life treatment choices. Interviews with the programmes' medical directors augment quantitative analysis. When all known participant characteristics are accounted for, substantial amount of variation attributed to the programme indicator variable remains. Programme effect explains 36% of the variation in "do not resuscitate" choice. 66% of the choice of artificial feeding, and 50% relating to the presence of health care proxy. The variation in treatment choices attributable to the programme of enrolment and the interviews with medical directors suggest that provider practice styles are important in determining patients' choices at the end of life. Interventions to enhance advance care planning should target care providers. (RH). |
| Accession Number | CPA-051118220 A |
| Classmark | LK: LV: QA: IKR: 7T |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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