Palliative care, specialized medical care focused on providing relief from the symptoms and stress of serious illness, is increasingly recognized for its ability to improve the quality of life for patients and their families. A recent report, America’s Care of Serious Illness: 2019 State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals, sheds light on the current landscape of palliative care access across the United States, revealing significant disparities and highlighting the urgent need for broader availability of Best Palliative Care Programs.
The study, conducted by the Center to Advance Palliative Care (CAPC) and the National Palliative Care Research Center (NPCRC), indicates a positive trend in the growth of hospital-based palliative care teams. Currently, 72 percent of US hospitals with fifty or more beds offer palliative care teams, a substantial increase from just 7 percent in 2001. These programs now serve an impressive 87 percent of all hospitalized patients nationwide, demonstrating the expanding reach of these vital services.
However, the report underscores a critical issue: access to these best palliative care programs is far from uniform. As Dr. Diane E. Meier, director of CAPC and co-author of the study, points out, geographical location significantly dictates the availability of quality palliative care. This “geography is destiny” phenomenon means that where a patient resides often determines their access to the symptom relief, emotional support, and improved quality of life that palliative care programs are designed to provide. With an aging population and a growing number of individuals living with serious and chronic illnesses, the need to address these disparities and expand access to comprehensive palliative care programs is more pressing than ever.
Key Findings: State of Palliative Care Access in US Hospitals
The 2019 report card reveals a state-by-state breakdown of palliative care access, with some states demonstrating significantly better integration of these services than others. Key findings include:
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State Performance: Three-quarters of US states have achieved a grade of A or B in terms of palliative care access. The number of states earning an A grade, indicating that over 80 percent of their hospitals have palliative care teams, has risen to 21, a considerable jump from only 3 in 2008. This positive trend suggests a growing recognition of the importance of palliative care programs at the state level.
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Leading States: Four states – Delaware, New Hampshire, Rhode Island, and Vermont – stand out as leaders, with palliative care teams present in every hospital with fifty or more beds. Several others, including Connecticut, the Dakotas, Utah, and the District of Columbia, are very close to achieving full penetration, demonstrating a strong commitment to providing best palliative care programs across their healthcare systems.
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States Lagging Behind: In contrast, Mississippi, Alabama, Oklahoma, New Mexico, and Wyoming are identified as the lowest-performing states. In these regions, fewer than 40 percent of hospitals report having palliative care teams, indicating significant gaps in access to these essential services and a clear need for improvement in establishing palliative care programs.
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Hospital Type and Location: Large nonprofit hospitals situated in urban centers are the most likely to offer palliative care programs. Conversely, for-profit hospitals, regardless of size, are less likely to provide palliative care compared to their nonprofit counterparts. Furthermore, access remains particularly limited for individuals in rural America. A striking 90 percent of hospitals with palliative care services are located in urban areas, while only 17 percent of rural hospitals with fifty or more beds offer these programs, highlighting a critical disparity in access for rural communities seeking best palliative care programs.
The Value of Palliative Care: Enhancing Quality of Life and Healthcare Efficiency
The report emphasizes the profound benefits of palliative care, citing evidence that high-quality palliative care programs not only improve the quality of life for patients and their families but also enhance their overall healthcare experience. Moreover, in certain illnesses, palliative care has been shown to extend patient lifespan. Dr. R. Sean Morrison, director of the NPCRC and co-author of the study, further highlights the positive impact of palliative care on hospital efficiency and cost-effectiveness, noting its ability to reduce unnecessary healthcare spending.
Palliative care is defined as specialized healthcare for individuals facing serious illnesses. It takes a holistic approach, focusing on alleviating the physical, emotional, and spiritual distress associated with illness. Delivered by a team of specially trained professionals, palliative care works in conjunction with a patient’s other medical treatments to provide an added layer of support. It is appropriate at any age and at any stage of a serious illness, and can be integrated with curative and life-prolonging treatments, offering a comprehensive approach to care. By addressing the multifaceted needs of patients and families, best palliative care programs play a crucial role in improving overall well-being and healthcare outcomes.
Policy Recommendations and Future Directions
The report suggests that federal and state policymakers have a vital role to play in expanding access to and improving the quality of palliative care programs. Key areas for policy focus include:
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Workforce Development: Investing in training and education to expand the palliative care workforce is essential to meet the growing demand for these services.
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Research Advancement: Continued research is needed to further demonstrate the benefits of palliative care and to develop innovative approaches to care delivery.
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Clinical Skill Enhancement: Initiatives to improve clinical skills in palliative care among healthcare professionals across all settings are crucial.
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Public Awareness Campaigns: Raising public awareness about the benefits of palliative care can help ensure that more patients and families can access these valuable services.
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Payment Model Innovation: Developing payment models that incentivize quality and value in palliative care is essential to promote widespread adoption and sustainability of best palliative care programs.
Several states are already taking proactive steps, developing new initiatives and enacting supportive legislation to advance palliative care within their borders. These efforts are encouraging and demonstrate a growing commitment to ensuring that all individuals living with serious illness have access to the best palliative care programs possible, regardless of their location or socioeconomic status.
