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J Gen Intern Med. 2012 Oct;27(10):1287-93. Epub 2012 May 4.

End-of-life care from the perspective of primary care providers.

Author information

1
Veterans Administration, Health Services Research and Development Center of Excellence, 300 North Ingalls Building, Room 7C27, Box 5429, Ann Arbor, MI USA. mariajs@umich.edu

Abstract

PURPOSE:

To explore the factors influencing primary care providers' ability to care for their dying patients in Michigan.

METHODS:

We conducted 16 focus groups to explore the provision of end-of-life care by 7 diverse primary care practices in southeast Michigan. Twenty-eight primary care providers and 22 clinical support staff participated in the study. Interviews were analyzed using thematic analysis.

RESULTS:

Primary care providers (PCPs) wanted to care for their dying patients and felt largely competent to provide end-of-life care. They and their staff reported the presence of five structural factors that influenced their ability to do so: (1) continuity of care to help patients make treatment decisions and plan for the end of life; (2) scheduling flexibility and time with patients to address emergent needs, provide emotional support, and conduct meaningful end-of-life discussions; (3) information-sharing with outside providers and within the primary care practice; (4) coordination of care to address patients' needs quickly; and (5) authority to act on behalf of their patients.

CONCLUSIONS:

In order to provide end-of-life care, PCPs need structural supports within primary care for continuity of care, flexible scheduling, information-sharing, coordination of primary care, and protection of their authority.

PMID:
22555775
PMCID:
PMC3445687
DOI:
10.1007/s11606-012-2088-3
[Indexed for MEDLINE]
Free PMC Article

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