4131.0: Tuesday, October 23, 2001 - 1:00 PM

Abstract #24512

Measuring end of life care in managed care: A descriptive study of Medicare + Choice enrollees in New England

Amy L. Gluckin, MPH and Qi Zhou, MD, MBA. Clinical Quality Measurement, Tufts Health Plan, 333 Wyman St., P.O. Box 9112, Waltham, MA 02454-9112, 781-466-9425 x8778, amy_gluckin@tufts-health.com

More seniors are enrolling in managed care organizations through Medicare + Choice than ever before and the average age of Medicare enrollees is increasing. One of the major challenges facing managed care organizations today is end of life care. Improvement efforts for end of life care have lagged behind other quality improvement initiatives due to the inherent difficulty of measuring end of life care and the lack of quality reporting requirements. This paper presents the results of a descriptive study of end of life care among enrollees of Tufts Health Plan, a managed care organization with over 100,000 Medicare + Choice members in New England. Through a retrospective study of a sample of Tufts Health Plan members, end of life care benefits, service utilization, and medication management prior to death was examined. A sub-population of patients (over 450 enrollees) diagnosed with chronic illness including circulatory, respiratory, and neoplasm disease, was examined to further understand use of care patterns. This population was selected due to the high proportion of elder seniors identified with these diagnoses. Use of hospital services, ambulatory services, skilled nursing facilities, hospice care, pharmacy, and community services were analyzed. The major objectives of this research were to better understand the range of end of life care received and aid in the development of outcome measures for end of life care.

Learning Objectives: At the conclusion of the session the participant will be able to identify target areas for future research and resource allocation for end of life care measures.

Keywords: End-of-Life Care, Quality of Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Tufts Health Plan
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA