THE TRANSPROFESSIONAL MODEL OF TERMINAL CARE: REFORMING END-STAGE CARE IN HIV/AIDS (HOSPICE, IMMUNE DEFICIENCY).
Contributors: University of Southern California.
Published: 1996
Number of pages: 319
Subjects: Social Work.; Health Sciences, Nursing.; Health Sciences, Health Care Management.
Description: This study evaluated the impact of models of care for terminally ill HIV/AIDS patients with respect to their acknowledgment of the terminal prognosis, admissions to hospice, and costs of service delivery. Terminal patients ($N=168$) were randomly assigned for home care services either to a conventional model of home care, case managed by a registered nurse ($N=78$), or to the transprofessional model of care, case managed by a registered nurse and a clinical social work team ($N=81$). The transprofessional care providers were competent in both medical/surgical care and palliative care. All patients were admitted by their physicians for home based medical services. Patients entered home care after having experienced at least one acute hospital episode with one of the opportunistic infections that define full blown AIDS.

Results showed that the conventional model of care was focused on the biological and physiological aspects of the disease, while the transprofessional model focused on bio-psychosocial aspects of the care. The two models of care differed with regard to arrangement of service delivery. Skilled nursing was the predominant mode of care in the conventional model, while the transprofessional model was a blending of nursing and social work service delivery.

The transprofessional model of care produced a greater number of acknowledgments of the terminal prognosis by patients ($p=.002$) than was so in the alternate treatment group. Acknowledgments occurred earlier in the care process in the transprofessional model than in the conventional model ($p=.07$). The percentage of patients admitted to hospice from the transprofessional model was significantly larger than the national average of hospice admits for terminal patients ($p=.001$); and the transprofessional model produced twice as many days on hospice service than the conventional model ($p=.08$). Overall, the transprofessional model of care reduced costs of terminal care by $2,612 per patient over the conventional model of care ($p=.02$). The transprofessional model demonstrated both lower labor costs and lower medication costs.
Notes: Source: Dissertation Abstracts International, Volume: 57-09, Section: A, page: 4129.

Thesis (PH.D.)--UNIVERSITY OF SOUTHERN CALIFORNIA, 1996.

School code: 0208.