title: Health services research on end-of-life care.
abstract: OBJECTIVE
  To summarize and discuss recent research aimed at evaluating palliative care services, and other complex interventions in end-of-life care.
  
  
  RESULTS
  Innovative approaches for the evaluation of complex interventions are highly relevant in end-of-life care. The Medical Research Council Framework for the development and evaluation of complex interventions uses the classic approach to research for drug development, but with a wider range of study methods, including experimental. This approach has been used in some recent research and has proved useful for the evaluation of effectiveness of palliative care services. Moreover, during recent years some experimental studies have explored feasibility, effectiveness and costs of complex programs to improve the quality of end-of-life care. Finally, the effectiveness of population-based educational interventions has been shown by one study focused on the preferences and attitudes on end-of-life care.
  
  
  CONCLUSIONS
  Health services research is crucial in end-of-life care because of the complex services and patients and families cared for. Health services research can provide information about the most effective (and cost-effective) strategies to improve the quality of end-of-life care. During recent years some interesting research and study protocols dealing with the evaluation of complex end-of-life programs have been designed and implemented.
authors.affiliation: Regional Palliative Care Network, National Cancer Research Institute, Genova, Italy. massimo.costantini@istge.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Costantini
authors.forename: Monica
authors.initials: M
authors.lastname: Beccaro
mesh_terms: D017028:Caregivers / Q000523:psychology; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D020380:Needs Assessment; D010166:Palliative Care / Q000379:methods* / Q000592:standards; D011787:Quality of Health Care; D013727:Terminal Care / Q000379:methods* / Q000592:standards