{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T21:09:31Z","timestamp":1778620171044,"version":"3.51.4"},"reference-count":25,"publisher":"Elsevier BV","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/100008572","name":"University of Ottawa","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008572","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000018","name":"The College of Family Physicians of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000018","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["-181577"],"award-info":[{"award-number":["-181577"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012665","name":"Institute for Clinical Evaluative Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012665","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jamda.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American Medical Directors Association"],"published-print":{"date-parts":[[2025,9]]},"DOI":"10.1016\/j.jamda.2025.105766","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:31:49Z","timestamp":1753273909000},"page":"105766","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physician Billing in Long-Term Care Homes and the Association With the Prescribing of End-of-Life Symptom Management Medications: A Population-Based Retrospective Cohort Study"],"prefix":"10.1016","volume":"26","author":[{"given":"Rhiannon L.","family":"Roberts","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna E.","family":"Clarke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Howard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darly","family":"Dash","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kobewka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirley H.","family":"Bush","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aynharan","family":"Sinnarajah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Simon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarina R.","family":"Isenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Arya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benoit","family":"Robert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Lau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Tanuseputro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Downar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9193-5386","authenticated-orcid":false,"given":"Colleen","family":"Webber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jamda.2025.105766_bib1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1001\/jama.291.1.88","article-title":"Family perspectives on end-of-life care at the last place of care","volume":"291","author":"Teno","year":"2004","journal-title":"JAMA"},{"key":"10.1016\/j.jamda.2025.105766_bib2","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1503\/cmaj.050626","article-title":"What matters most in end-of-life care: perceptions of seriously ill patients and their family members","volume":"174","author":"Heyland","year":"2006","journal-title":"Can Med Assoc J"},{"key":"10.1016\/j.jamda.2025.105766_bib3","series-title":"End-of-Life Care During the Last Days and Hours","year":"2011"},{"key":"10.1016\/j.jamda.2025.105766_bib4","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.jpainsymman.2017.06.010","article-title":"Safety and effectiveness of palliative drug treatment in the last days of life\u2014a systematic literature review","volume":"55","author":"Jansen","year":"2018","journal-title":"J Pain Symptom Manage"},{"key":"10.1016\/j.jamda.2025.105766_bib6","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.jamda.2023.11.026","article-title":"Palliative end-of-life medication prescribing rates in long-term care: a retrospective cohort study","volume":"25","author":"Tanuseputro","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib7","doi-asserted-by":"crossref","DOI":"10.1016\/j.jamda.2024.105076","article-title":"Enablers and barriers for end-of-life symptom management medications in long-term care homes: a qualitative study","volume":"25","author":"Roberts","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib8","doi-asserted-by":"crossref","first-page":"411","DOI":"10.7326\/0003-4819-150-6-200903170-00010","article-title":"Nursing home physician specialists: a response to the workforce crisis in long-term care","volume":"150","author":"Katz","year":"2009","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jamda.2025.105766_bib9","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1093\/geront\/gnaa141","article-title":"Medical care delivery in U.S. Nursing homes: current and future practice","volume":"61","author":"Katz","year":"2021","journal-title":"Gerontologist"},{"key":"10.1016\/j.jamda.2025.105766_bib10","doi-asserted-by":"crossref","first-page":"1942","DOI":"10.1016\/j.jamda.2022.04.011","article-title":"Physician practice in Ontario nursing homes: defining physician commitment","volume":"23","author":"Correia","year":"2022","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib11","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s00455-014-9590-1","article-title":"Swallowing problems at the end of the palliative phase: incidence and severity in 164 unsedated patients","volume":"30","author":"Bogaardt","year":"2015","journal-title":"Dysphagia"},{"issue":"Sup1","key":"10.1016\/j.jamda.2025.105766_bib12","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.12968\/bjon.2014.23.Sup1.S20","article-title":"Intravenous versus subcutaneous access for palliative care patients","volume":"23","author":"Gabriel","year":"2014","journal-title":"Br J Nurs"},{"key":"10.1016\/j.jamda.2025.105766_bib13","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jamda.2020.09.043","article-title":"Diagnostic testing in long-term care and resident emergency department visits: a retrospective cohort study","volume":"22","author":"Kunkel","year":"2021","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib14","series-title":"Changes in Health, End-Stage Disease and Signs and Symptoms (CHESS) Scale","year":"2021"},{"key":"10.1016\/j.jamda.2025.105766_bib15","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1034\/j.1601-5215.2002.51017.x","article-title":"The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people","volume":"51","author":"Hirdes","year":"2003","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.jamda.2025.105766_bib16","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s12904-022-01059-3","article-title":"The interRAI CHESS scale is comparable to the palliative performance scale in predicting 90-day mortality in a palliative home care population","volume":"21","author":"Williams","year":"2022","journal-title":"BMC Palliat Care"},{"key":"10.1016\/j.jamda.2025.105766_bib17","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/0825859717741027","article-title":"Palliative medicine\u2014becoming a subspecialty of the Royal College of Physicians and Surgeons of Canada","volume":"32","author":"Pilkey","year":"2017","journal-title":"J Palliat Care"},{"key":"10.1016\/j.jamda.2025.105766_bib18","doi-asserted-by":"crossref","first-page":"E292","DOI":"10.9778\/cmajo.20150005","article-title":"Identification of the physician workforce providing palliative care in Ontario using administrative claims data","volume":"3","author":"Barbera","year":"2015","journal-title":"CMAJ Open"},{"key":"10.1016\/j.jamda.2025.105766_bib19","doi-asserted-by":"crossref","first-page":"1750","DOI":"10.1111\/jgs.12441","article-title":"Association between proportion of provider clinical effort in nursing homes and potentially avoidable hospitalizations and medical costs of nursing home residents","volume":"61","author":"Kuo","year":"2013","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.jamda.2025.105766_bib20","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.2546","article-title":"Clinicians who practice primarily in nursing homes and the quality of end-of-life care among residents","volume":"7","author":"Ghosh","year":"2024","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jamda.2025.105766_bib21","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1016\/j.jamda.2018.12.017","article-title":"Association between clinician specialization in nursing home care and nursing home clinical quality scores","volume":"20","author":"Ryskina","year":"2019","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib22","doi-asserted-by":"crossref","first-page":"2387","DOI":"10.1001\/jama.289.18.2387","article-title":"Patterns of functional decline at the end of life","volume":"289","author":"Lunney","year":"2003","journal-title":"JAMA"},{"key":"10.1016\/j.jamda.2025.105766_bib23","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1136\/bmj.330.7498.1007","article-title":"Illness trajectories and palliative care","volume":"330","author":"Murray","year":"2005","journal-title":"BMJ"},{"key":"10.1016\/j.jamda.2025.105766_bib24","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-037466","article-title":"Barriers and facilitators to optimal supportive end-of-life palliative care in long-term care facilities: a qualitative descriptive study of community-based and specialist palliative care physicians\u2019 experiences, perceptions and perspectives","volume":"10","author":"Harasym","year":"2020","journal-title":"BMJ Open"},{"key":"10.1016\/j.jamda.2025.105766_bib25","doi-asserted-by":"crossref","DOI":"10.1016\/j.jamda.2024.105112","article-title":"Describing nursing home physicians with competence or focused practice in caring for older adults","volume":"25","author":"Dash","year":"2024","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105766_bib26","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jamda.2023.10.024","article-title":"Focusing on provider quality measurement: continued consensus and feasibility testing of practice-based quality measures for primary care providers in long-term care","volume":"25","author":"Dash","year":"2024","journal-title":"J Am Med Dir Assoc"}],"container-title":["Journal of the American Medical Directors Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152586102500283X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152586102500283X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:10:08Z","timestamp":1778616608000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S152586102500283X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":25,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["S152586102500283X"],"URL":"https:\/\/doi.org\/10.1016\/j.jamda.2025.105766","relation":{},"ISSN":["1525-8610"],"issn-type":[{"value":"1525-8610","type":"print"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Physician Billing in Long-Term Care Homes and the Association With the Prescribing of End-of-Life Symptom Management Medications: A Population-Based Retrospective Cohort Study","name":"articletitle","label":"Article Title"},{"value":"Journal of the American Medical Directors Association","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jamda.2025.105766","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 Post-Acute and Long-Term Care Medical Association.","name":"copyright","label":"Copyright"}],"article-number":"105766"}}