Improving the quality of life of palliative and chronic disease patients and carers in remote Australia with the establishment of a day respite facility

Carey, Timothy A.; Schouten, Kellie; Wakerman, John; Humphreys, John Stirling; Miegel, Fred; Murphy, Simon; Arundell, Mick

doi:10.1186/s12904-016-0136-1

Cited by 9 publications

(16 citation statements)

References 11 publications

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“…These findings add further support to the suggestion of the benefits of improved symptom management. When the results of this study are considered in conjunction with the findings from the qualitative study [ 9 ] the overall impression appears to be that the support provided by the respite service resulted in an improvement in disease management by the provision of primary health care support, including support with medications, wound care, daily nutrition, and social and emotional support. The literature strongly indicates that a significant proportion of the deaths and hospital admissions in the NT are avoidable [ 12 ].…”

Section: Discussionmentioning

confidence: 92%

“…To address the growing need of palliative and chronic disease patients in a remote Australian town, a day respite service was established. As well as demonstrating that the service had beneficial effects on the quality of life of patients and carers [ 9 ] it was also of interest to assess the financial implications of the service. The specific questions being answered in this study were: What happens to hospital admission and ventilator hour usage following the introduction of a day respite service.…”

Section: Discussionmentioning

confidence: 99%

“…While at the facility, participants could engage in various unstructured leisure and social activities such as cooking, watching television, and socialising with staff and other patients. A qualitative study of the impact of the facility on patients and carers indicated that the facility had a substantial positive impact on both patients’ and carers’ quality of life and that spending time at the facility was highly valued [ 9 ]. During the study period, 23 people were referred to the service by seven different agencies including the Alice Springs Hospital, a Health Department Palliative Care Service, an Aboriginal Medical Service, and an Aboriginal Aged Care Service.…”

Section: Methodsmentioning

confidence: 99%

“…The establishment of a day respite facility in Alice Springs provided an opportunity to examine the benefits to patients and carers in terms of an improved quality of life and also to hospitals in terms of reduced admissions and financial savings. Improvements in quality of life for both patients and carers were demonstrated through the qualitative study [ 9 ]. The current paper reports on the financial impact on the hospital of the respite service.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, the research question that guided this study was: What happens to hospital admissions and ventilator hour usage following the introduction of a day respite service? Results related to the impact on patients and carers as well as the clinical effectiveness of the service are beyond the scope of the current study but have been discussed extensively in the qualitative study accompanying this research [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Reducing hospital admissions in remote Australia through the establishment of a palliative and chronic disease respite facility

et al. 2017

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BackgroundThere are limited respite services for palliative care patients and their families in the Northern Territory (NT). The high prevalence of complex chronic diseases, limited access to primary care services, and the poor living situations of many Aboriginal and Torres Strait Islander Australians result in high hospitalisation rates and pressure on tertiary health services. Palliative Care NT identified a need for a flexible, community based, culturally appropriate respite service in Alice Springs. It was of particular interest to assess the impact of the respite service on the extent to which hospital resources were accessed by this population of patients.MethodsRespite service use and hospital use data were collected over two time periods: the 12 months prior to the establishment of the service; and the first 10 months of the operation of the service. The financial implications of the facility were assessed in terms of the National Weighted Activity Unit (NWAU). Of primary interest in this study was the impact of the respite service on admissions to the Emergency Department (ED), to the Wards, and to the Intensive Care Unit (ICU). The amount of ventilator hours consumed was also of interest.ResultsOverall, there was a mean cost saving of $1882.50 per episode for hospital admissions with a reduction in: hospital admissions; mean length of stay; Intensive Care Unit (ICU) hours; and ventilator hours.ConclusionsThe establishment of the respite service has met an important and unmet need in Alice Springs: provision of respite where none has existed before. The service did assist with savings to the health department which could contribute to the cost of the facility over time. Two features of the respite facility that may have contributed to the savings generated were the enhanced coordination of care for patients with complex chronic diseases, as well as improved medication compliance and symptom management.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Reducing hospital admissions in remote Australia through the establishment of a palliative and chronic disease respite facility

et al. 2017

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The effectiveness of community-based palliative care programme components: a systematic review

Hughes,

Vernon,

Hainstock

2023

Age and Ageing

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Background There is evidence that community-based palliative care programmes can improve patient outcomes and caregiver experiences cost-effectively. However, little is known about which specific components within these programmes contribute to improving the outcomes. Aim To systematically review research that evaluates the effectiveness of community-based palliative care components. Design A systematic mixed studies review synthesising quantitative, qualitative and mixed-methods study findings using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PROSPERO: ID # CRD42022302305. Data sources Four databases were searched in August 2021 (CINAHL, Web of Science, ProQuest Federated and PubMed including MEDLINE) and a close review of included article references. Inclusion criteria required articles to evaluate a single, specific component of a community-based palliative care programme either within an individual programme or across several programmes. Results Overall, a total of 1,674 articles were identified, with 57 meeting the inclusion criteria. Of the included studies, 21 were qualitative, 25 were quantitative and 11 had mixed methods. Outcome measures consistently examined included patient/caregiver satisfaction, hospital utilisation and home deaths. The components of standardised sessions (interdisciplinary meetings about patients), volunteer engagement and early intervention contributed to the success of community-based palliative care programmes. Conclusions Certain components of community-based palliative care programmes are effective. Such components should be implemented and tested more in low- and middle-income countries and key and vulnerable populations such as lower-income and marginalised racial or ethnic groups. In addition, more research is needed on the cost-effectiveness of individual programme components.

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Outcomes reported in evaluations of programs designed to improve health in Indigenous people

Chando

Howell

Young

et al. 2021

Health Services Research

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Objective To assess the outcomes reported and measured in evaluations of complex health interventions in Indigenous communities. Data Sources We searched all publications indexed in MEDLINE, PreMEDLINE, EMBASE, PsycINFO, EconLit, and CINAHL until January 2020 and reference lists from included papers were hand‐searched for additional articles. Study Design Systematic review. Data Collection/Extraction Methods We included all primary studies, published in peer‐reviewed journals, where the main objective was to evaluate a complex health intervention developed specifically for an Indigenous community residing in a high‐income country. Only studies published in English were included. Quantitative and qualitative data were extracted and summarized. Principal Findings Of the 3523 publications retrieved, 62 evaluation studies were included from Australia, the United States, Canada, and New Zealand. Most studies involved less than 100 participants and were mainly adults. We identified outcomes across 13 domains: clinical, behavioral, process‐related, economic, quality of life, knowledge/awareness, social, empowerment, access, environmental, attitude, trust, and community. Evaluations using quantitative methods primarily measured outcomes from the clinical and behavioral domains, while the outcomes reported in the qualitative studies were mostly from the process‐related and empowerment domains. Conclusion The outcomes from qualitative evaluations, which better reflect the impact of the intervention on participant health, remain different from the outcomes routinely measured in quantitative evaluations. Measuring the outcomes from qualitative evaluations alongside outcomes from quantitative evaluations could result in more relevant evaluations to inform decision making in Indigenous health.

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Improving the quality of life of palliative and chronic disease patients and carers in remote Australia with the establishment of a day respite facility

Cited by 9 publications

References 11 publications

Reducing hospital admissions in remote Australia through the establishment of a palliative and chronic disease respite facility

Reducing hospital admissions in remote Australia through the establishment of a palliative and chronic disease respite facility

The effectiveness of community-based palliative care programme components: a systematic review

Outcomes reported in evaluations of programs designed to improve health in Indigenous people

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