The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Improving Palliative Care for Cancer
ents, as well as health care team conferences—should be taken into account in setting reimbursement levels and in actually paying claims forthese services when providers bill for them.
Information on palliative and end-of-life care is largely absent from materials developed for the public about cancer treatment. In addition, reliable information about survival from different types and stages of cancer is not routinely included with treatment information.
Recommendation 5: Organizations that provide information about cancertreatment (NCI, the American Cancer Society, and other patient-orientedorganizations [e.g., disease-specific groups], health insurers and pharmaceutical companies) should revise their inventories of patient-orientedmaterial, as appropriate, to provide comprehensive, accurate informationabout palliative care throughout the course of disease. Patients would alsobe helped by having reliable information on survival by type and stage ofcancer easily accessible. Attention should be paid to cultural relevance andspecial populations (e.g., children).
Practice guidelines for palliative care and for other end-of-life issues are in comparatively early stages of development, and quality indicators are even more embryonic. Progress toward their further development and implementation requires continued encouragement by professional societies, funding bodies, and payers of care.
Recommendation 6: Best available practice guidelines should dictate thestandard of care for both physical and psychosocial symptoms. Care systems, payers, and standard-setting and accreditation bodies shouldstrongly encourage their expedited development, validation, and use. Professional societies, particularly the American Society of Clinical Oncology, the Oncology Nursing Society, and the Society for Social Work Oncology, should encourage their members to facilitate the development andtesting of guidelines and their eventual implementation, and should provide leadership and training for nonspecialists, who provide most of thecare for cancer patients.
Recommendation 7: The recommendations in the NCPB report,Enhancing Data Systems to Improve the Quality of Cancer Care(seeAppendix B) should be applied equally to palliative and end-of-life care as to otheraspects of cancer treatment. These recommendations include
developing a core set of cancer care quality measures;
increasing public and private support for cancer registries;
supporting research and demonstration projects to identify newmechanisms to organize and finance the collection of data for cancer carequality studies;