Scalable principles of community-based high-value care for seriously ill individuals: Diamonds in the rough.
Early, integrated palliative care has been shown to improve quality of life and reduce utilization in both inpatient and outpatient settings. As health systems shift to risk-based payment structures, palliative care will play an increasing role in improving value of care outside of the hospital. Based on successful models of community-based palliative care, we identify six principles - interdisciplinary team-based care; 24/7 access and responsiveness; concurrent palliative care with disease-directed treatment; targeting services to high-risk patients; integrated medical and social supports; and caregiver support - that are widely implemented because of their impact on improving value for seriously ill individuals.
Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. Electronic address: rbparikh@partners.org.
Ravi B
RB
Parikh
Center to Advance Palliative Care, New York, NY, United States.
Brynn
B
Bowman
Center to Advance Palliative Care, New York, NY, United States; Hospice and Palliative Nurses Association, Pittsburgh, PA, United States.
Constance
C
Dahlin
Center to Advance Palliative Care, New York, NY, United States.
Jeanne S
JS
Twohig
Center to Advance Palliative Care, New York, NY, United States; Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Diane E
DE
Meier
D003422:Critical Care / Q000191:economics / Q000379:methods; D016638:Critical Illness / Q000191:economics*; D006282:Health Personnel / Q000639:trends; D006801:Humans; D010166:Palliative Care / Q000191:economics* / Q000379:methods; D010348:Patient Care Team / Q000639:trends