title: First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service.
abstract: BACKGROUND
  There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers.
  
  
  OBJECTIVE
  To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District.
  
  
  METHODS
  This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees.
  
  
  RESULTS
  Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P < .05) and stable symptom management over time. Fewer emergency department ( P < .001) and inpatient hospital admissions ( P < .001) occurred among enrollees while on the palliative care service.
  
  
  CONCLUSIONS
  An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.
authors.affiliation: 1 Union College, Schenectady, NY, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Pouliot
authors.affiliation: 1 Union College, Schenectady, NY, USA.
authors.forename: Carol S
authors.initials: CS
authors.lastname: Weisse
authors.affiliation: 2 VNS of Northeastern New York, Schenectady, NY, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Pratt
authors.affiliation: 2 VNS of Northeastern New York, Schenectady, NY, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: DiSorbo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards; D006764:Hospitals, Community / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009518:New York; D064691:Nurses, Community Health / Q000458:organization & administration / Q000592:standards; D010166:Palliative Care / Q000458:organization & administration / Q000592:standards; D017060:Patient Satisfaction; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life
keywords: community hospital; hospitalizations; in-home; palliative care; partnerships; quality of life; satisfaction; visiting nurse service