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Table 3 Summary of Evaluation Consistent with RE-AIM and Mapped to Objectives

From: Care plus study: a multi-site implementation of early palliative care in routine practice to improve health outcomes and reduce hospital admissions for people with advanced cancer: a study protocol

Objective Hypothesis Evaluation domain Method
1. To reduce acute hospitalisation days for patients with advanced cancer Implementation of Care Plus will reduce the acute hospitalisation days in the last 90 days of life by 25% for patients with advanced cancer. Effectiveness Comparison of the outcome variable for patients enrolled during the control versus the practice change periods using linked data from hospital medical records, routinely collected state-based administration datasets (i.e. MBS/PBSa), and the death registry.
2. Improve timely access to palliative care Implementation of Care Plus will increase by 25% the proportion of patients with advanced cancer referred to palliative care at least 90 days before death Reach
3. Improve quality of end of life care Care Plus will decrease by 25% the proportion of patients experiencing > 1 indicator of poor-quality end of life care Effectiveness
4. Assess the acceptability of Care Plus Care Plus will be acceptable to patients, families & healthcare providers Adoption Implementation Focus groups and individual interviews with patients & healthcare providers
5. To assess the fidelity of Care Plus delivery Care Plus will be delivered according to the core elements prescribed in more than 50% of patients Adoption Implementation Review of Care Plus consultations recorded using PC-NATb + medical audit of outpatient visits, GP case conferences
6. Assess the impact of Care Plus implementation on total cost of healthcare Implementation of Care Plus will reduce total health system costs incurred in last 90 days of life Implementation Maintenance Comparison of total health system costs for patients enrolled during the control versus the practice change periods using linked hospital & MBS/PBS data
  1. aMBS/PBS Medicare Benefits Schedule provides information of health services provided outside hospitals /Pharmaceutical Benefits Schedule provides information of prescribing outside hospitals in Australia;
  2. bPC-NAT – Palliative Care Needs Assessment Tool