How prevalent are hospital-based palliative care programs? Status report and future directions

Area of Science:

• Palliative Care
• Health Services Research
• Geriatrics

Background:

• Most deaths in the U.S. occur in hospitals, often with unsatisfactory end-of-life experiences for patients and families.
• Hospital-based palliative care programs (HBPCPs) offer a solution to improve inpatient end-of-life care.
• Existing data on the prevalence and characteristics of HBPCPs in the U.S. is limited.

Purpose of the Study:

• To determine the prevalence and characteristics of hospital-based palliative care programs in the United States.
• To establish a baseline for future comparisons of HBPCP development and patterns.
• To identify common structures, service areas, and future needs of HBPCPs.

Main Methods:

• Phase 1: Utilized the American Hospital Association (AHA) 1998 Annual Survey to identify hospitals with end-of-life care (EOLC) or pain management (PM) services.
• Phase 2: Conducted a focused survey of hospitals identified in Phase 1 to gather detailed information on their palliative care programs.
• Analyzed survey data to determine the existence, structure, and characteristics of HBPCPs.

Main Results:

• Out of 2,015 unique hospitals with EOLC or PM services, 337 (30%) reported having an HBPCP, and 228 (20.4%) planned to establish one.
• HBPCPs are commonly structured as inpatient consultation services or hospital-based hospices.
• These programs are frequently based in oncology, general medicine, and geriatrics departments.

Conclusions:

• Hospital-based palliative care programs are present in a significant portion of U.S. hospitals, with many more planning to develop.
• Understanding the current landscape of HBPCPs is essential for guiding future resource allocation, education, and program development.
• These findings provide a critical benchmark for the growth and evolution of inpatient palliative care services.