End-of-Life Care

People at the end of life require specialized care that is focused on symptom management, pain control, and patient comfort. This care can be provided by palliative care specialists or by hospice agencies. Unfortunately, however, many people die without any palliative or hospice care interventions.

The End-of-Life Care group at UMass Medical School’s Center for Health Policy and Research is investigating palliative and hospice care services to understand why these services are underused and to develop policy recommendations and strategies to improve their appropriate use.

The Center for Health Policy and Research is also working to improve and develop planning strategies to advance care, which can help ensure that individuals at the end of life have their wishes respected and adhered to by medical professionals.

Key Projects

Improving Hospitalist Referrals to Hospice in an Acute Care Hospital
There is an increasing trend to use hospital-based physicians, or hospitalists, for in-patient acute care. It is unclear however, whether hospitalists consistently have discussions with patients and families about the benefits of hospice services. This study is designed to identify the barriers to communication about hospice and referrals to hospice among hospitalists and to design a targeted intervention to improve referral rates.

MassHealth Hospice Program: Overview and Analysis
The Medicaid hospice benefit is an optional state plan service and as such its format varies across the country. This cost and utilization study is designed to evaluate the MassHealth hospice program and identify opportunities for improvement.

The Medical Orders for Life-Sustaining Treatment (MOLST) Demonstration in Massachusetts
Advance directives and health care proxy laws vary from state to state. The Center for Health Policy and Research is working with the Massachusetts Executive Office of Health and Human Services to develop a demonstration project for a Medical Orders for Life-Sustaining Treatment (MOLST) system in Massachusetts. The objective is to develop a physician-signed, legally-binding medical order which would cover four domains of care: resuscitation, medical intervention, antibiotics and artificially-administered fluids and nutrition.

Learn More

Center for Health Policy and Research
(508) 856-3124
healthpolicy@umassmed.edu