Understanding complexity and care needs
Research type
Research Study
Full title
Understanding complexity and care needs: testing potential case-mix criteria within episodes of palliative care across inpatient, community and outpatient settings
IRAS ID
172938
Contact name
Fliss E M Murtagh
Contact email
Duration of Study in the UK
0 years, 11 months, 30 days
Research summary
In England, the hospice movement has provided a model of excellent care (palliative care) for those with advanced progressive disease. However, there are marked inequities in provision of this care across England. Those older or with non-cancer, for instance, are less likely to receive palliative care. There are also major geographical variations in NHS provision resulting in often poor match between the palliative care needs of a patient/family, the resources provided to meet those needs, and patient health outcomes achieved.
This study is Workstream 3 of a five year NIHR funded C-CHANGE project (RP-PG-1210-12015). This study includes only adults receiving specialist palliative care, and extends across both cancer and non-cancer advanced conditions, and across inpatient, community and outpatient settings. It is a 12 month prospective survey testing potential case-mix criteria in individual episodes of care across eight sites. This will be used in development of a case-mix classification for palliative care in England. A case-mix classification groups people by complexity.
Clinicians will collect data on sites about the participants on demographic and clinical data, episode start and end data, potential case-mix variables (e.g., phase of illness, functional status and problem severity) alongside information on patient-level resource use in specialist palliative care settings. These data will be anonymised, encrypted, transferred to the central database and analysed to understand how we can better match patient-level resource use to their need.
This study will lead directly to patient benefit through improved matching of resources to needs at individual patient-level and will better enable the NHS to deliver high quality, patient-centred palliative care in last year of life. The results will not only suggest whether there is an underlying classification of palliative care, but also provide the evidence to link these to robust measurable quality and outcome indicators of palliative care in the last year of life.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
15/LO/0887
Date of REC Opinion
2 Jul 2015
REC opinion
Further Information Favourable Opinion