Does Palliative Care Improve Quality? A Survey of Bereaved Family Members

Palliative care (PC) is the interdisciplinary specialty that aims to relieve suffering and improve the quality of care for patients with serious illness and their families. Although PC programs are becoming increasingly prevalent in United States hospitals, the impact of hospital PC consultation programs on the quality of care received by family members is not well understood. We conducted prospective quantitative telephonic interviews of family members of patients who died at Mount Sinai Medical Center between April and December 2005 employing the validated “After-Death Bereaved Family Member Interview, ” to assess quality of medical care at the end-of-life. Multivariable techniques were used to compare family satisfaction of PC patients versus usual care (UC) patients controlling for age, race (white versus non-white), diagnosis (cancer versus non-cancer), socio-economic status (Medicaid versus non-Medicaid) and functional status (number of dependent activities of daily living). One hundred ninety eligible subjects were contacted and successful interviews were completed with 149 (78.4%) family members (54 PC and 95 UC patients). PC showed benefit, with 65 % of PC patients ’ family members reporting that their emotional or spiritual needs were met, as compared to 35 % of UC patients ’ family members (P=0.004). Sixty-seven percent of PC patients ’ family members reported confidence in one or more self-efficacy domains, as compared to 44 % of UC patients ’ family members (P=0.03). Our study shows that PC consultation is associated with improved satisfaction with attention to family and enhanced self-efficacy. PC offers a unique approach by integrating the needs of the family into the care of the patient