Hospital-based palliative care programs that focus on patient comfort rather than simply medical treatment are growing rapidly. And for patients, their families, and hospitals themselves, that is a very good thing.
A new study by the National Palliative Care Research Center finds the number of these important new programs has grown from 600 to more than 1500 over the past decade. Of the nation’s 2,500 hospitals with at least 50 beds, more than 60 percent now offer palliative care. These teams, which may include a specially-trained physician, a nurse, social worker, chaplain, and pharmacist, work closely with patients and their families to help coordinate what are often complex medical, spiritual, and social needs.
Despite common belief, palliative care is not the same as hospice care and is available to people who have serious illnesses but who may not be dying. In addition, palliative care teams do not replace a patient’s specialist or primary care doctor. Rather, they supplement regular care provided by their physicians. As a patient, you can receive palliative care and remain under the care of your regular doctor.
The growth of these teams is great news. Recent studies have shown palliative care reduces suffering and distress as well as painful and unnecessary treatments and tests. It cuts costs and–most striking–can help people live longer.
Yet, hospital-based palliative care programs still have a long way to go. Not only do more than a third of hospitals still not have them, but many that do fail to properly coordinate palliative care with standard treatment. Research shows that when these teams are not well integrated with attending physicians, they are often unsuccessful.
In addition, while these programs have caught on in many states, they still have a long way to go in others. For example, while all or nearly all hospitals in Vermont, Maryland, Minnesota, and Nebraska have programs, fewer than half the hospitals in 11 other states have them. Among the worst performers are Mississippi, where only one-in-five hospitals provide this care, and Delaware, Alabama and Alaska, where fewer than one in three do.
Palliative care program also suffer from shortages of specialists who are well trained in this care. The study found that only about 86 palliative care fellows are trained each year–far too few to meet the need. Remarkably, Medicare does not pay teaching hospitals to train doctors in this speciality, even though it both improves quality of care and saves money.
Palliative care is rapidly becoming a standard part of care for hospital patients with serious illnesses, but it still has a long way to go.
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