title: Improving care at lower cost for end-stage heart and lung disease: integrating end of life planning with home care.
abstract: Patients with advanced heart and lung disease experience exacerbations resulting in hospitalizations and interventions the patient may not desire. Strategies are needed that address end of life issues, honor preferences, and improve care without increasing cost. This study examines the impact on hospitalization and care cost of an integrated system of end of life care and interdisciplinary home care for mid-Missouri veterans with advanced congestive heart failure or chronic obstructive pulmonary disease.
authors.affiliation: Home and Community-Based Care, Department of Veterans Affairs Central Office, Washington, DC, USA.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Edes
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Lindbloom
authors.forename: Jon L
authors.initials: JL
authors.lastname: Deal
authors.forename: Richard W
authors.initials: RW
authors.lastname: Madsen
mesh_terms: D032722:Advance Care Planning / Q000458:organization & administration*; D000368:Aged; D003363:Cost Control; D019033:Delivery of Health Care, Integrated; D006302:Health Services Research; D006333:Heart Failure / Q000191:economics / Q000628:therapy*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008923:Missouri; D010348:Patient Care Team; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000628:therapy*; D011785:Quality Assurance, Health Care; D013727:Terminal Care / Q000592:standards*; D014481:United States; D014493:United States Department of Veterans Affairs