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Magnitude of the Problem • Quality of Care: As many as 50% of those with cancer or other terminal illnesses experience unrelieved pain or other symptoms during their final days. 1 • Cost: Patients with higher costs had worse quality of death in their final week of life. 2 • Impact on Families and Caregivers: Being a caregiver who is experiencing mental or emotional strain is an independent risk factor for mortality among elderly spousal caregivers. 3 • Access to Services: Despite an overwhelming desire to die at home, only ¼ of Americans die at home. 4 1 Rao, JK, et al. (2002). Am J Prev Med, 23, 215-‐200 2 Zhang, B., et al. (2009). Arch Intern Med, 169, 480-‐488 3 Schulz, R. & Beach, SR. (1999). JAMA, 282, 2215-‐2219 4 Grunier, A, et al. (2007). Medical Care Research Review, 64, 351-‐378.
Conceptual Framework of Key Determinants
Page 1 and 2: This work is licensed under a Creat
Page 3 and 4: Presentation Outline � Consider t
Page 5 and 6: What Does Health at the CuraNve Car
Page 7: Problem Definition At present in th
Page 11 and 12: Setting Priorities & Recommending I
Page 13 and 14: Developing a Communication Strategy
Page 15: Acknowledgements � JHBSPH faculty

Slides - Johns Hopkins Bloomberg School of Public Health

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