Unequal Access to Hospital Palliative Care in the United States: A State-by-State Report Card (RP518)

Rogers, Maggie; Meier, Diane E.; Moreno, Jaison; Heitner, Rachael; Aldridge, Melissa

doi:10.1016/j.jpainsymman.2020.04.110

Cited by 1 publication

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“…Data from the National Hospice and Palliative Care Organization [ 27 ] indicate that patients with a principal diagnosis of dementia had the largest number of days of care on average in 2017, and access to palliative care including hospice care is on the rise. Indeed, in the US, hospice care for nursing home residents serves many residents with dementia [ 28 ], and 72% of hospitals were found to have palliative care programs, yet with gaps in access to these programs [ 29 ]. Despite this progress, in the US, people living with a serious illness including dementia still do not have reliable access to palliative care, and there is marked variability in program prevalence by hospital type in the US [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…Indeed, in the US, hospice care for nursing home residents serves many residents with dementia [28], and 72% of hospitals were found to have palliative care programs, yet with gaps in access to these programs [29]. Despite this progress, in the US, people living with a serious illness including dementia still do not have reliable access to palliative care, and there is marked variability in program prevalence by hospital type in the US [29].…”

Section: Access To Palliative (And Hospice) Carementioning

confidence: 99%

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Palliative Care in Advanced Dementia: Comparison of Strategies in Three Countries

et al. 2021

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Palliative care including hospice care is appropriate for advanced dementia, but policy initiatives and implementation have lagged, while treatment may vary. We compare care for people with advanced dementia in the United States (US), the Netherlands, and Israel. We conducted a narrative literature review and expert physician consultation around a case scenario focusing on three domains in the care of people with advanced dementia: (1) place of residence, (2) access to palliative care, and (3) treatment. We found that most people with advanced dementia live in nursing homes in the US and the Netherlands, and in the community in Israel. Access to specialist palliative and hospice care is improving in the US but is limited in the Netherlands and Israel. The two data sources consistently showed that treatment varies considerably between countries with, for example, artificial nutrition and hydration differing by state in the US, strongly discouraged in the Netherlands, and widely used in Israel. We conclude that care in each country has positive elements: hospice availability in the US, the general palliative approach in the Netherlands, and home care in Israel. National Dementia Plans should include policy regarding palliative care, and public and professional awareness must be increased.

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Section: Resultsmentioning

confidence: 99%