Establishing a regional, multisite database for quality improvement and service planning in community-based palliative care and hospice.

BACKGROUND: Outpatient palliative care, an evolving delivery model, seeks to improve continuity of care across settings and to increase access to services in hospice and palliative medicine (HPM). It can provide a critical bridge between inpatient palliative care and hospice, filling the gap in community-based supportive care for patients with advanced life-limiting illness. Low capacities for data collection and quantitative research in HPM have impeded assessment of the impact of outpatient palliative care. APPROACH: In North Carolina, a regional database for community-based palliative care has been created through a unique partnership between a HPM organization and academic medical center. This database flexibly uses information technology to collect patient data, entered at the point of care (e.g., home, inpatient hospice, assisted living facility, nursing home). HPM physicians and nurse practitioners collect data; data are transferred to an academic site that assists with analyses and data management. Reports to community-based sites, based on data they provide, create a better understanding of local care quality. CURRENT STATUS: The data system was developed and implemented over a 2-year period, starting with one community-based HPM site and expanding to four. Data collection methods were collaboratively created and refined. The database continues to grow. Analyses presented herein examine data from one site and encompass 2572 visits from 970 new patients, characterizing the population, symptom profiles, and change in symptoms after intervention. CONCLUSION: A collaborative regional approach to HPM data can support evaluation and improvement of palliative care quality at the local, aggregated, and statewide levels.

Inventory and evaluation of natural resources for regional agricultural planning

Includes bibliography

Informe de relatoría: VIII Consejo Regional de Planificación = ILPES: report of the Eighth Regional Council for Planning

Contiene asistencia, organización de los trabajos y resumen de los debates centrados en la propuesta de agenda. Incluye en anexos: lista provisional de participantes, de documentos, propuesta de agenda, y resoluciones.

Relationship between physical, regional and national planning: the Jamaican situation

Publicado también con el símbolo CEPAL/CARIB 80/7

Informe del Seminario Regional sobre la Dimensión Ambiental en la Planificación del Desarrollo = Report of the Regional Seminar on the Environmental Dimension in Developing Planning

Confronta las experiencias y conceptos sobre la incorporacion de la dimension ambiental en la planificacion del desarrollo, y explora para ello, proposiciones que permitan hacer mas efectiva la referida incorporacion a la luz de las dificultades y oportunidades que se presentan en la actual crisis de la region.