Promotors:
Kenneth Chambaere (Vrije Universiteit Brussel)
Project Partners:
Vrije Universiteit Brussel
Budget uitgereikt door Kom op tegen Kanker:
€124.000
Samenvatting
Day care centres remain a marginal service in the Flemish palliative care landscape. Ever since their founding – as a pilot project of the Federal Government – they have been operating in a very tight financial space. Government support is still minimal which makes the centres dependent of donations and fundraising and thwarts their chances of growth. Yet, according to the palliative care bodies, palliative day care may represent a meaningful care concept in health care and complementary to existing (palliative) care services. Policymakers (and KOTK) also support this idea, but require a rigorous analysis and evaluation of the service, to inform them about the direction in which to rethink or optimise the service’s operation and provision, and about further steps in policy and financing. The centres themselves are supportive of such a thorough evaluation through consultancy and independent research, with the end goal of pinpointing their added value, adapting their service and finding their place in the (palliative) care landscape.
Existing research on palliative day care in Flanders has been primarily aimed at exploratively studying the perceptions of involved stakeholders, i.e. patients, family caregivers and care professionals, but not at mapping the impact on targeted outcomes. Also, nothing is known about the health economic impact of palliative day care in terms of a so-called “return on investment” effect (i.e. the investment cost for day care centres is compensated by a reduction of general health care costs as a consequence of day care centre visits). Internationally some initiatives, most notably the UK Palliative Day Care Project Group, have investigated the impact of palliative day care or similar services, employing both descriptive and interventional research methods. Results are mixed and definitive conclusions are therefore difficult to draw. The evidence base for their effectiveness remains slender, particularly due to the methodological difficulties in designing evaluation research obtaining the necessary numbers for adequate statistical power, finding a control group with equally diverse profiles, or the impossibility of baseline measurements. Apart from these methodological difficulties, there is the issue of international comparability of results given the likely differences in operation and care concepts of day care centres in different countries.
Given the knowledge gap described above, the research aims of this project proposal are:
a) To study the (care) needs of the target group, i.e. both patients and their informal caregivers, and to what extent these needs are met by palliative day care centres. In this context, users’ reasons, expectations and wishes related to visiting day care centres will be surveyed, as well as which problems they encounter in using palliative day care services.
b) To study the health economic impact of palliative day care, i.e. whether their use, intensity and/or timing are associated with variation in total health care consumption for patients at the end of life, particularly length of stay at home, dying at home, hospital admissions, and use of other healthcare services, medication and interventions.
Existing research on palliative day care in Flanders has been primarily aimed at exploratively studying the perceptions of involved stakeholders, i.e. patients, family caregivers and care professionals, but not at mapping the impact on targeted outcomes. Also, nothing is known about the health economic impact of palliative day care in terms of a so-called “return on investment” effect (i.e. the investment cost for day care centres is compensated by a reduction of general health care costs as a consequence of day care centre visits). Internationally some initiatives, most notably the UK Palliative Day Care Project Group, have investigated the impact of palliative day care or similar services, employing both descriptive and interventional research methods. Results are mixed and definitive conclusions are therefore difficult to draw. The evidence base for their effectiveness remains slender, particularly due to the methodological difficulties in designing evaluation research obtaining the necessary numbers for adequate statistical power, finding a control group with equally diverse profiles, or the impossibility of baseline measurements. Apart from these methodological difficulties, there is the issue of international comparability of results given the likely differences in operation and care concepts of day care centres in different countries.
Given the knowledge gap described above, the research aims of this project proposal are:
a) To study the (care) needs of the target group, i.e. both patients and their informal caregivers, and to what extent these needs are met by palliative day care centres. In this context, users’ reasons, expectations and wishes related to visiting day care centres will be surveyed, as well as which problems they encounter in using palliative day care services.
b) To study the health economic impact of palliative day care, i.e. whether their use, intensity and/or timing are associated with variation in total health care consumption for patients at the end of life, particularly length of stay at home, dying at home, hospital admissions, and use of other healthcare services, medication and interventions.