Measurement of quality of care and quality of life at the end of life.
OBJECTIVE
Consumers and providers demand better indicators for quality of care and quality of life at the end of life. This article presents recommendations for advancing the science of measurement at end of life.


METHODS
The authors reviewed the extant literature and applied the Institute of Medicine's conceptual framework for national health care quality to end-of-life care and research.


RESULTS
Ten recommendations were developed, charting a course for research that will improve the quality of care delivered and, consequently, the quality of life experienced at life's end.


CONCLUSIONS
Measurement bridges the conceptual and operational levels of scientific research, clinical care, and quality improvement. Although a large amount of psychometric groundwork has been laid in the field of end-of-life research, the next wave of studies will ideally take measurement at end of life to a higher level of rigor and precision.
Tilden
Virginia P
VP
Center for Ethics in Health Care, Oregon Health & Science University, Portland, OR 97201-3098, USA. tildenv@ohsu.edu
Tolle
Susan
S
Drach
Linda
L
Hickman
Susan
S
D003625:Data Collection / Q000379:methods; D006801:Humans; D011594:Psychometrics / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods*; D019984:Quality Indicators, Health Care; D013727:Terminal Care; D014481:United States