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What is health services research? What is health services research?
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Health services research in palliative care and end-of-life care Health services research in palliative care and end-of-life care
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Research designs for service evaluation of complex interventions Research designs for service evaluation of complex interventions
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Randomized controlled trials Randomized controlled trials
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Cluster randomized controlled trials Cluster randomized controlled trials
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Stepped wedge design Stepped wedge design
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Observational designs Observational designs
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Challenges in the evaluation of palliative care interventions and services Challenges in the evaluation of palliative care interventions and services
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Defining the intervention Defining the intervention
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Determining outcome measures Determining outcome measures
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Randomization Randomization
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Achieving recruitment and minimizing attrition Achieving recruitment and minimizing attrition
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Heterogeneity of the patient group Heterogeneity of the patient group
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Obtaining informed consent Obtaining informed consent
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Conclusion Conclusion
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References References
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Online references Online references
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19.8 Health services research in palliative care and end-of-life care
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Published:March 2015
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Abstract
Health services research in palliative care and end-of-life care involves the study of palliative care needs, access and quality of palliative care, and the feasibility, effectiveness, and cost of palliative and end-of-life care services and interventions. The evaluation of services and interventions involving patients with advanced illness presents unique challenges, both ethical and methodological. In this chapter, several research designs that are useful for the service evaluation of complex interventions in palliative care and end-of-life care are discussed and examples of studies using these designs are described. The designs that are described include both experimental and non-experimental designs. The problems and challenges that doing research with dying patients presents are subsequently described and possible solutions proposed. The challenges dealt with in this chapter include defining the intervention, determining relevant outcome measures, randomization of patients to intervention and control group, achieving recruitment and minimizing attrition, heterogeneity of the patient group, and obtaining informed consent.
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