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Updated January 6, 2005
When individuals in today's society are dying, they often feel forced to decide between life-prolonging medical care and hospice support for themselves and their families. Under the direction of Michael W. Rabow, MD, assistant clinical professor in medicine, researchers at UC-San Francisco's Collaborative Innovation in Primary Care Program and the Hospice by the Bay are collaborating to address this all-too-common problem in today's American health care system.
According to Rabow, researchers are conducting a controlled trial to evaluate a Comprehensive Care Team project in which palliation of symptoms and reasonable curative attempts are pursued simultaneously, health care is not viewed as a war against death, and comfort care is not seen by patients, families and health care workers as an ‘all-or-nothing' choice.
This program's interdisciplinary team of doctors, nurses and social workers provides comprehensive care and family caregiver support for seriously ill outpatients who are near the end of their lives. Using a case management model, the program draws heavily on local volunteer support services, faith communities and social agencies.
The Comprehensive Care Team project employs a sophisticated randomized study to assess the feasibility, impact and cost-effectiveness of removing the dichotomy between life-prolonging care and hospice-type services. Under the Comprehensive Care Team, patients receive state-of-the-art medical care and at the same time, hospice, or palliative care.
The project assesses the team's impact on patient quality of life, level of symptom control, psychosocial and spiritual well being, advance care planning and health care utilization. The program provides regional and national health care planners with valuable data concerning the costs of merging medical care with palliative or hospice care.
Promoting Excellence in End-of-Life Care is a national program of The Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit PromotingExcellence.org for more resources.
