Number of palliative care teams more than doubled since 2000

Results of an analysis conducted by the Center to Advance Palliative Care and the National Palliative Care Research Center showed that 63% of US hospitals with at least 50 beds now employ a palliative care team, an increase of 138.3% in the past decade.

The report said the number of hospitals with a palliative care team increased from 658 (24.5%) in 2000 to 1,568 in 2009. The percentage of hospitals with a palliative care program increased each year.

Overall, 951 hospitals with a cancer center also reported having a palliative care program.

The primary source of hospital data used for the analysis was the American Hospital Association Annual Survey Database for fiscal years 2000 to 2009.

Center to Advance Palliative Care director Diane E. Meier, MD, told Infectious Diseases in Children that a combination of administrators, executives, physicians and patients were pushing for expanded access to palliative care. The Center to Advance Palliative Care tries to emphasize the benefits of palliative care to each individual audience.

“Palliative care takes a system that was not designed for the very sick, very complex patient that is not benefiting from hospital care as usual and designs an intervention modeled to meet their needs,” she said. “Although that group of patients constitutes a small percentage of the patient population, they account for substantially more than two-thirds of total hospital costs. Palliative care teams try to get the system to work for those very complex, expensive patients.”

The largest hospitals were most likely to have a palliative care program; 85% of hospitals with at least 300 beds reported having a program. That number drops to 54% for hospitals with 50 to 299 beds and 22% for institutions with fewer than 50 beds.

Slightly more than half (51%) of hospitals in the South were likely to have a palliative care program. Meier said almost all medical schools and teaching hospitals have palliative care programs, and those schools and hospitals are concentrated in the Northeast. Additionally, she said most quality-of-life research is being conducted in the Northeast.

“Research outcomes tend to influence the institution where the research was done,” Meier said.

A national survey conducted by the firm Public Opinion Strategies in May asked respondents about their opinions on palliative care, which was defined as specialized medical care for people with serious illnesses focused on providing patients with relief from the symptoms, pain and stress of a serious illness. The results showed that 95% said patients with serious illness and their families should be educated about palliative care; 92% agreed they would be likely to consider palliative care for a loved one if they had a serious illness; and 92% of respondents said palliative care services be made available at all hospitals for patients with serious illness and their families.

Only 30% of the public was knowledgeable about palliative care, according to the survey. Most likely, less than 15% was truly knowledgeable about palliative care, Meier said, adding that she saw that as a good thing because it is much harder to change misconception than to create a perception.

“This gives us an opportunity to get the message out in an accurate and coherent way,” she said. “The message is that palliative care is essentially an added layer of support that helps patients and families, along with the rest of the medical care team, to ensure the best possible quality of life while patients and families are pursuing disease treatment.” – by Jason Harris

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