Measurement of quality of care and quality of life at the end of life.

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Abstract
Purpose: Consumers and providers demand better indicators for quality of care and quality of life at the end of life. This article presents recommendations for advancing the science of measurement at end of life. Design and Methods: The authors reviewed the extant literature and applied the Institute of Medicine's conceptual framework for national health care quality to end-of-life care and research. Results: Ten recommendations were developed, charting a course for research that will improve the quality of care delivered and, consequently, the quality of life experienced at life's end. Implications: Measurement bridges the conceptual and operational levels of scientific research, clinical care, and quality improvement. Although a large amount of psychometric groundwork has been laid in the field of end-of-life research, the next wave of studies will ideally take measurement at end of life to a higher level of rigor and precision.