Aims
The aims of the C-CHANGE programme were to report the costs of specialist palliative care; develop and test a person-centred, nationally applicable casemix classification for adult specialist palliative care provision in England; accurately capture the complex needs of patients with advanced disease in last year of life; better quantify those needs; and support more equitable allocation of resources to meet them.
The programme also aimed to identify ways to measure the improvements in health status and well-being which patients and families experience following specialist palliative care so that the casemix classification could be developed, but also so that quality and effectiveness of services can be more readily demonstrated to patients, families, commissioners and services.
Objectives
The C-CHANGE programme had five objectives:
- to refine, validate or test new and existing person-centred outcome measures to assess the main health status and symptoms/concerns of, and services received by, patients and families receiving specialist palliative care
- to utilise the perspectives of key stakeholders (i.e. patients, families, professional caregivers, commissioners and policy-makers) on complexity in palliative care to inform subsequent casemix development
- to understand the criteria which distinguish different models of palliative care to help inform how a casemix classification and per-patient funding models can best be utilised across different models of specialist palliative care
- to develop a person-centred palliative care casemix classification, based on individual patient and family needs and costs of care, for adults with both cancer and non-cancer conditions in the last year of life
- to test this person-centred palliative care casemix classification in terms of its ability to predict resource use in last year of life and to better understand transitions between services in order to improve care.