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 |