|Targeted News Service|
Americans express strong views when asked about the care that they want to receive when they are dying. In general, they prefer to die at home and to remain in charge of decisions about their care. However, evidence suggests these wishes are not likely to be fulfilled.
Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, a new report from the
The report offers recommendations for changes in policy, financing mechanisms and payment practices, workforce developments, research, and clinical and supportive care. The recommendations presented focus specifically on those with "a serious illness or medical condition who may be approaching death."
The committee overseeing this report, which includes
Specifically, the committee recommends the following:
* All health insurers should cover the provision of comprehensive care for individuals with advanced serious illness who are nearing the end of life.
* Measurable, actionable, and evidence-based quality standards for clinician-patient communication and advance care planning should be developed and change as needed to reflect the evolving population and health system needs to be consistent with emerging evidence, methods, and technologies.
* Educational institutions, credentialing bodies, accrediting boards, state regulatory agencies, and health care delivery organizations should establish the appropriate training, certification, and/or licensure requirements to strengthen the palliative care knowledge and skills of all clinicians who care for individuals with advanced serious illness who are nearing the end of life.
* Federal, state, and private insurance and health care delivery programs should integrate the financing of medical and social services to support the provision of quality care consistent with the values, goals, and informed preferences of people with advanced serious illness nearing the end of life. To the extent that additional legislation is necessary to implement this recommendation, the administration should seek and
* Civic leaders, public health and other governmental agencies, community-based organizations, faith-based organizations, consumer groups health care delivery organizations, payers, employers, and professional societies should engage their constituents and provide fact-based information about care of people with advanced serious illness to encourage advance care planning and informed choice based on the needs and values of individuals.
"The steps outlined in this report represent a clear challenge to redesign and reallocate the system and benefits to allow people near the end of life to receive social services that help them remain at home or in the community, which is where many prefer to be," said Peres. "Harmonizing medical and social services for people and their families near the end of life helps eliminate provider incentives to shift dollars [and] ensures people receive care in the right setting at the right time in accordance with their informed preferences and values."
Or for more information, please click here (http://altarum.org/publications/iom-report-provides-roadmap-for-end-of-life-care).
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