{"id":17507,"date":"2024-02-28T09:45:57","date_gmt":"2024-02-28T14:45:57","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=17507"},"modified":"2024-03-07T10:58:43","modified_gmt":"2024-03-07T15:58:43","slug":"evaluating-the-association-between-the-implementation-of-the-poet","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/evaluating-the-association-between-the-implementation-of-the-poet\/","title":{"rendered":"Evaluating the association between the implementation of the PoET (Prevention of Error-Based Transfers) Southwest Spread Project and palliative care provision: a quasi-experimental matched cohort study using population-level health administrative data"},"content":{"rendered":"<p><strong>Objectives<\/strong> \u2014 The PoET (Prevention of Error-based Transfers) project seeks to align long-term care (LTC) home informed consent practices to existing legislation, thereby reducing consent-related error-based transfers to acute care. We sought to measure changes in resident-level palliative care provision after participating in the PoET Southwest Spread Project (PSSP), and to identify patient and LTC home characteristics associated with palliative care provision.<\/p>\n<p><strong>Design<\/strong> \u2014 Quasi-experimental matched (1:1 ratio) cohort study design using linked population-based health administrative data.<\/p>\n<p><strong>Setting<\/strong> \u2014 Sixty LTC homes (PSSP = 30; Control = 30) in Ontario, Canada, from November 2019 to December 2021.<\/p>\n<p><strong>Methods<\/strong> \u2014 We matched 30 PSSP to 30 control homes and described incidence rates for resident-level palliative care provision (ie, physician palliative care encounters and palliative medication prescriptions) during the 7-month postimplementation period. We used generalized linear mixed models to evaluate the association between PSSP implementation and palliative care provision during the postimplementation period. We adjusted for resident-level characteristics (ie, age, sex, comorbidity status) and home-level characteristics (ie, rurality status, profit model, COVID-19 impact). We identified a decedent subcohort to measure palliative care provision patterns during the last 2 months of life.<\/p>\n<p><strong>Results<\/strong> \u2014 We captured a matched cohort of 8894 residents (PSSP = 4103; Control = 4791). Incidence rates of palliative care encounters increased during the postimplementation period for PSSP (82.6 to 85.4 per 100 person-months) but not for control residents (68.8 to 65.3 per 100 person-months). After adjusting for key covariates, PSSP exposure was associated increased palliative care provision (incidence rate ratio 2.47, 95% CI 2.31-2.64) and palliative care medication prescription (1.16, 95% CI 1.12-1.20). Larger home size, certain health regions, and higher number of comorbidities were associated with increased physician palliative care encounters.<\/p>\n<p><strong>Conclusions and Implications<\/strong> \u2014 By promoting correct informed consent practices in LTC, PSSP participation increased palliative care provision for PSSP LTC residents across all settings.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objectives \u2014 The PoET (Prevention of Error-based Transfers) project seeks to align long-term care (LTC) home informed consent practices to existing legislation, thereby reducing consent-related error-based transfers to acute care. We sought to measure changes in resident-level palliative care provision after participating in the PoET Southwest Spread Project (PSSP), and to identify patient and LTC [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[33,62,32],"migration-helper-qa-sample-set":[],"class_list":["post-17507","journal_article","type-journal_article","status-publish","hentry","topic-end-of-life-care","topic-health-services-research","topic-long-term-care-and-continuing-care"],"acf":{"citation":"Siu HYH, Hafid S, Kirkwood D, Elston D, Perez R, Jones A, Oliver J, Chidwick P, Nitti T, Costa A. <em>J Am Med Dir Assoc<\/em>. 2024; Feb 28 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1016\/j.jamda.2024.01.025","ices_scientist":[16709,1276,1186],"site":[6737],"research_program":[6740],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Evaluating the association between the implementation of the PoET (Prevention of Error-Based Transfers) Southwest Spread Project and palliative care provision: a quasi-experimental matched cohort study using population-level health administrative data<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 The PoET (Prevention of Error-based Transfers) project seeks to align long-term care (LTC) home informed consent practices to existing\" \/>\n<meta name=\"robots\" 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