title: The development of a palliative care program for managed care patients: a case example.
abstract: Palliative care is emerging as an important new field. Although programs are developing in hospital environments, little is known about development of programs in outpatient practices or those serving large managed care populations. This article provides a framework for the development of a comprehensive palliative care program in a large multispecialty group practice that serves managed care patients. The article addresses guiding principles, the need for obtaining baseline data, how the clinical consultation service was established, development of outcomes measures, and information on current program status. Five themes emerged as key to successful program development, most importantly the close collaboration between administrative and clinical staff in all aspects of program development.
authors.affiliation: Palliative and Supportive Medicine Program, Harvard Vanguard Medical Associates, Boston, Massachusetts 02215, USA.
authors.forename: G
authors.initials: G
authors.lastname: Gazelle
authors.forename: R
authors.initials: R
authors.lastname: Buxbaum
authors.forename: E
authors.initials: E
authors.lastname: Daniels
mesh_terms: D000368:Aged; D019985:Benchmarking; D003625:Data Collection / Q000379:methods; D005260:Female; D006125:Group Practice, Prepaid / Q000458:organization & administration*; D017048:Health Care Costs; D006801:Humans; D007342:Insurance Benefits; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D008404:Massachusetts; D008875:Middle Aged; D019982:Organizational Case Studies; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team; D016730:Program Development; D012017:Referral and Consultation; D013727:Terminal Care / Q000458:organization & administration*