Palliative care access varies widely in US

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There has been rapid growth of new, innovative palliative care consultation services in the US’s hospitals. More than half of the 50-bed or larger hospitals in the U.S. offer palliative care services to ease pain and suffering for seriously ill patients and their families.

However, the availability of these services varies widely across geographic regions, according to a study published in the October 2008 issue of the peer-reviewed, Journal of Palliative Medicine. The study is available online at

Whereas in 2000 only a few hospitals in the U.S. provided palliative care services, this report documents a steady overall increase in adoption of palliative care, with 52.8% of hospitals surveyed offering services aimed at alleviating pain and suffering. The number of large hospitals (>249 beds) with palliative care programs has increased to 72.2%, while fewer small hospitals (>50 beds) reported offering these services. Growth in palliative care has occurred mainly in not-for-profit hospitals and has been most notable in the midwestern and western regions of the U.S.

Benjamin Goldsmith, Jessica Dietrich, MPH, Qingling Du, MS, and R. Sean Morrison, MD, from the National Palliative Care Research Center, and Center to Advance Palliative Care in New York, report these findings in a paper entitled, “Variability in Access to Hospital Palliative Care in the United States.”

“This paper documents the success and applicability of this new field of medicine in American health care. I hope it leads to the patient expectation that the expert relief of suffering will be as routine in hospitals as cardiology or surgery,” says Charles F. von Gunten, MD, PhD, Editor-in-Chief of the Journal and Provost, Institute for Palliative Medicine at San Diego Hospice.

Importantly, the study found that 84% of medical schools were associated with at least one hospital that has a palliative care program. This positive finding implies that future doctors will have access to training in palliative care, facilitating its incorporation into their daily patient care routines.

Additionally, the authors observed that the availability of palliative care services is inversely related to Medicare expenditures. “This implies that palliative care is consistent with other innovations-when the right care is applied to the right patient at the right time, overall costs go down because futile or ineffective approaches are abandoned in favor of the effective new intervention,” says von Gunten.

Source: Mary Ann Liebert, USA

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