Effects of an Advanced Illness Care Coordination Program on Patient- Provider Communication, Patient Satisfaction, and Support of Surrogates
Toseland, Ronald, Institute of Gerontology, University at Albany, Suny, Albany, NY, USA, Tobin, Daniel, The Life Institute, VA Healthcare Network Upstate New York, USA, Engelhardt, Joseph, The Life Institute, VA Healthcare Network Upstate New York, USA, McClive, Kimberly, Institute of Gerontology, University at Albany, Suny, Albany, NY, USA |
This study examined the effectiveness of an Advanced Illness Coordinated Care Program (AICCP) for individuals with advanced cancer, COPD, and heart disease. AICCP is a twelve-week intervention focusing on four major areas: (1) counseling, (2) education, (3) advocacy, and (4) care coordination. The program was provided primarily to elderly patients and involved six individual and family meetings with a social worker or nurse. At six health care sites, 253 patients with advanced illness were assigned to AICCP or usual care. Both groups were assessed within two weeks before the beginning of AICCP, and then again at three months after baseline on a variety of psychological and program evaluation measures. The results indicate that AICCP was effective in increasing patient satisfaction with communication between practitioners and patients, patient satisfaction with health care, and improving spiritual and emotional support to surrogates. The program also increased the number of health care proxy and living will care directives documented in the medical record at both three and six months postbaseline. Implications for providing AICCP as routine care in end-of-life settings will be discussed.
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