Literature Review

Emphasis on financial vs nonfinancial criteria in employer benefits’ measurementsJAMA Health Forum; Jeffrey Pfeffer, PhD; Esther Olsen, MHA; Sara J. Singer, PhD; 1/25According to KFF, “60.4% of people [in the US] under age 65, or about 164.7 million people, had employment-sponsored health insurance in 2023.” Given employers’ large role in the health care ecosystem, what employers measure may affect access to care and how employees and their families interact with health care professionals. In a representative sample of 221 respondents involved in employer health benefits oversight, employers and their health benefits consultants focus more on financial than nonfinancial performance dimensions in both decision-making and measurement. To improve broader aspects of health plan performance, employer measurement and decision-making must emphasize nonfinancial as well as financial criteria.

Impact of patient and caregiver beliefs on utilization of hospice and palliative care in diverse patients with advanced lung cancerAmerican Journal of Hospice and Palliative Care; Melanie Besculides, Melissa B Mazor, Carolina Moreno Alvarado, Mayuri Jain, Lihua Li, Jose Morillo, Juan P Wisnivesky, Cardinale B Smith; 2/25A prospective cohort study of newly diagnosed patients ≥18 years old with advanced lung cancer and their caregivers was conducted. Participants completed validated surveys at multiple points and electronic health records were reviewed to evaluate utilization. Minoritized lung cancer patients held more negative beliefs about HC/PC [hospice care/palliative care] yet were more likely to receive HC/PC. Further work is needed to understand factors that impact utilization among diverse patients with advanced cancer.

Research priorities in neuropalliative care-A consensus statement from the International Neuropalliative Care SocietyJAMA Neurology; Winnie K. Lau, MD; Corey R. Fehnel, MD, MPH; Zachary A. Macchi, MD; Ambereen K. Mehta, MD, MPH; Manon Auffret, PharmD, PhD; Jori F. Bogetz, MD; Jori E. Fleisher, MD, MSCE; Jerome J. Graber, MD, MPH; Heather E. Leeper, MD, MS; Heena R. Manglani-Terranova, PhD; Susanne Muehlschlegel, MD, MPH; Emily L. Mroz, PhD; Elizabeth J. Pedowitz, MD; Usha Ramanathan, MSc, MD; Max Sarmet, SLP, MSc; Nathan A. Shlobin, BA; Leonard Sokol, MD; Susan Allyson Weeks, MA; Jiayun Xu, PhD, RN; Helen Bundy Medsger; Claire J. Creutzfeldt, MD; Ana-Maria Vranceanu, PhD; Darin B. Zahuranec, MD, MS; David Y. Hwang, MD; 2/25The International Neuropalliative Care Society Research Committee convened an interdisciplinary panel of experts, including clinicians, scientists, people with neurologic disease, and care partners, to identify priority research areas for the advancement of neuropalliative care as a field. Three priority areas highlighted in this review include (1) patient- and care partner–centered symptoms and outcomes specific to neurologic illness and tools for their assessment, (2) development of effective neuropalliative care interventions and delivery models, and (3) methods to support the ability to foster, deliver, and measure goal-concordant care over time.

The green ICU: how to interpret green? A multiple perspective approach Critical Care; by Elisabeth Smale, Heather Baid, Marko Balan, Forbes McGain, Scott McAlistar, Jan J. de Waele, Jan Carel Diehl, Erik van Raaij, Michel van Genderen, Dick Tibboel & Nicole Hunfeld; 2/18/25Mitigating environmental impacts is an urgent challenge supported by (scientific) intensive care societies worldwide. However, making green choices without compromising high-quality care for critically ill patients may be challenging. ... To put this challenge of achieving quality care standards with sustainable use of resources into perspective, the current paper pinpoints a three-step approach towards a green ICU by (I) measuring environmental sustainability, (II) outlining strategies to improve sustainability and (III) elaborating on how to communicate results to create a synergy of sustainability initiatives within ICUs. Editor's note: With its focus on care for critically ill patients, how might this three-step approach be applied to hospice GIP settings?

Long-term health care use among children surviving multiple organ dysfunctionJAMA Network Open; Robert Ohman, MD, MPH; Jerry J. Zimmerman, MD, PhD; 1/25Mortality outcomes of pediatric critical illness have improved over the last several decades, while concurrently the population of patients with technology dependency and complex chronic morbidities has continued to grow and the incidence of MOD [multiple organ dysfunction] has simultaneously increased. In the setting of declining critical illness mortality, pediatric outcomes research has broadened its scope to assess metrics beyond mortality, describing the trajectory of recovery from critical illness with measures of patient quality of life; physical, cognitive, and functional status; and family psychological and economic well-being. As the authors point out, assessment of the larger financial impact of this higher health care utilization on families themselves would be valuable future knowledge, as high health care utilization, appointments, and recurrent hospitalizations may detract from families’ ability to work, care for their other children, and attend to their own medical needs. Targeted support for families of survivors of MOD may be necessary to minimize these secondary impacts and to optimize outcomes for this vulnerable population of patients.

Lived experiences of patients hospitalized with acute decompensated heart failure and kidney dysfunctionJAMA Network Open; Gwen M. Bernacki, MD, MHSA; Ann M. O’Hare, MD, MA; Mahlet Assefa, MD; Kevin D. O’Brien, MD; David K. Prince, PhD; James N. Kirkpatrick, MD; Nisha Bansal, MD, MAS; Catherine R. Butler, MD, MA; 1/25This qualitative study of patients currently or recently hospitalized with ADHF [acute decompensated heart failure] and kidney dysfunction offers a window on the lived experiences of members of this medically vulnerable group. Study participants offered vivid accounts of how their illness had impacted their day-to-day lives, sense of self, life priorities, and hopes and expectations for the future. However, many lacked a detailed understanding of the medical aspects of their illness and did not always feel equipped or empowered to actively participate in their care. Our findings suggest that there may be untapped opportunities to improve quality of communication for patients with ADHF and kidney dysfunction. 

Sudden unexpected infant death and disparities in infant mortality in the US, 1999-2022JAMA Pediatrics; Elizabeth R. Wolf, MD, MPH; Frederick P. Rivara, MD, MPH; Anabeel Sen, MBBS, MPH; Steven H. Woolf, MD, MPH; 1/25This study found that infant mortality from SUID [sudden unexpected infant death] has increased significantly. Previous data through 2020 showed that SUID increased among Black infants. Our analysis, which included 2021 and 2022 data, showed a more generalized increase. Possible explanations include COVID-19 or other respiratory illnesses, maternal opioid use, and social media’s influence on infant sleeping practices. SUID mortality rates were notably higher among American Indian or Alaska Native, Black, and Native Hawaiian or Other Pacific Islander infants than among Asian and White infants. Disparities in SUID could reflect unsafe sleeping position, prematurity, tobacco exposure, and/or infant feeding practices; further research is needed.

Factors influencing the self-reported palliative care practices of acute care nursesWestern Journal of Nursing Research; Keshia Kotula, Catherine Dingley, Du Feng, Lori Candela, Megan Pfitzinger Lippe; 1/25 Provision of palliative care in acute care settings is significantly lacking despite evidence that early integration leads to better patient/family-related outcomes and improved healthcare cost and efficiency. A descriptive, cross-sectional design was used to examine the effects of personal and environmental factors on nurses’ palliative care practices in the acute care setting. Personal factors, especially self-efficacy and attitudes toward care of the dying, are the most significant influencing factors to the frequency of acute care nurses’ palliative care practices.

Hospice - The time is now for additional integrity oversightJAMA Forum; by Joan M. Teno; 4/23...Leading hospice organizations are calling for more oversight. The National Partnership for Healthcare and Hospice Innovation, LeadingAge, the National Association for Home Care & Hospice, and the National Hospice and Palliative Care Organization provided a comprehensive set of recommendations to preserve the integrity of hospice. These organizations are returning to the historic mission of hospice: to improve care for dying persons and support for their family members... The recommendations put forth by the 4 hospice organizations are important. Further reforms also are needed.

Care for patients with a history of immigrationJAMA; Margaret Wheeler, MS, MD; Juan Raul Gutierrez, MD; Alicia Fernandez, MD; 1/25Home to 20% of the world’s immigrants, the US is the leading destination for people leaving their birth countries, and the US Census estimates that almost 14% of the US population in 2022 was born outside the US. ... The 2023 US Preventive Services Task Force Guideline on screening for latent tuberculosis recommends screening for tuberculosis in patients from Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia because in 2020, 71% of cases of active tuberculosis in the US occurred among individuals from these areas. Assessment of clinically relevant premigration factors involves consideration of the epidemiology of disease, health care practices, and sociopolitical and environmental exposures in an immigrant’s country of origin. These factors can alter risk assessment in differential diagnoses; for example, neurocysticercosis should be considered in the differential diagnosis of seizures in a patient from Central America.

The National Donor Family Council: History, activities, achievements, and legaciesOmega-Journal of Death and Dying; Margaret B Coolican, Charles A Corr; 1/25The National Donor Family Council (NDFC) functioned under the sponsorship of the National Kidney Foundation from 1992-2014. Giving voice to the needs and views of donor families, the NDFC had an important impact on the support for those families. This article records significant points in the advocacy of donor families, summarizes the history of the NDFC, highlights the various activities and achievements of the NDFC, and offers some impressions of its legacies.

Flaws in the Medicare Advantage Star RatingsJAMA Health Forum; David J. Meyers, PhD, MPH; Amal N. Trivedi, MD; Andrew M. Ryan, PhD; 1/25The objective of the star ratings is to help beneficiaries select better plans, and to reward plans that deliver high-quality care. In June 2024, a US district court judge ruled that the Centers for Medicare and Medicaid Services (CMS) inappropriately calculated Medicare Advantage (MA) Star ratings due to not implementing a previously announced statistical adjustment. First, it is not clear if the star ratings are actually capturing a higher quality, as several measures in the star rating are reported by the plans themselves and plans often overstate their performance. Second, over 80% of contracts by enrollment are rated 4 stars or higher, which is the threshold needed to earn bonus payments, and a single star rating is assigned to each contract even when contracts may cover many different states and regions. Third, while bonus payments for star ratings are costly, plans eligible for enhanced bonuses have not shown greater improvement in measures related to clinical quality or administrative effectiveness. Taken together, the current star ratings are neither useful for all beneficiaries to make their plan decisions, nor do they appear to be capturing quality or catalyzing improvement. 

What is renal cell carcinoma?JAMA; Rebecca Voelker, MSJ; 1/25Renal cell carcinoma is a common cancer that forms in the kidneys. In 2023, an estimated 81,800 people were diagnosed with renal cell carcinoma in the US, making it the sixth most common cancer among males and the ninth among females. Renal cell carcinoma is most often diagnosed in people aged 60 to 70 years. Although the diagnosis has increased slightly in the US in recent years, deaths from renal cell carcinoma have declined. Although the survival rate of stage IV renal cell carcinoma varies among individuals, the average 5-year survival is 28%.