Prevalence of Palliative care programs

The use of palliative care teams in hospitals is growing, but there are still opportunities for improvement. The prevalence of palliative care in U.S. hospitals with 50 or more beds increased more than 157% between 2000 and 2011. https://www.capc.org/events/webinars/briefing-palliative-care-outlook-in-2021-results-of-a-national-survey/

Approximately 75% of all hospitals with more than 300 beds have palliative care teams. https://www.upmc.com/-/media/upmc/services/palliative-and-supportive-institute/resources/documents/psi-history-palliative-care.pdf.

However, access to palliative care varies considerably from state to state, with 100% of hospitals in some states offering palliative care services all the way down to a state (Mississippi), with only 33% of their hospitals providing palliative care services (Morrison & Meier, 2019).

Below are the significant findings by Morrison and Meier (2019) about the growth or lack of palliative care programs across the U.S. The hospitals were rated A, B, C, or D depending on patient access to palliative care. Here are the general findings followed by specific ratings in U.S. states. How does your state compare?

• Not-for-profit hospitals are seven times more likely to have a palliative care team than for-profit hospitals.
  
• 90% of hospitals with 300 beds or more have palliative care teams.
  
• 90% of hospitals operated by the Catholic Church have palliative care.
  
• Southern US states and the lowest number of palliative care teams in hospitals
  
• 96% of teaching hospitals now have palliative care teams, increasing the likelihood that the next generation of clinicians will receive training.
  
• Barriers to palliative care access include a too small workforce, an underdeveloped knowledge base, and a lack of payment models linked to quality measures. https://reportcard.capc.org/

There are also issues of barriers in palliative care for ethnic/racial minorities. Included in a report by CAPC, only 60% of public hospitals – which care for around 44 million patients who are disproportionately minorities, provide palliative care services (Chambers, 2020). Mayeda and Ward (2019) conducted a systematic review of nine articles that addressed improving information and access to palliative care for African Americans, Hispanic or Latinos, and Asian or Pacific Islanders populations. They found interventions that addressed education about palliative care, communication that included interpreters and addressed cultural issues, and community tailored interventions helped overcome barriers. See the page on culturally competent care for more information.

An additional assessment found of the 21 states that scored As, meaning their percentage of hospitals with palliative care teams was 80% or higher, 62% were in Democratic states, 24% switch votes between the two parties, and only 14% were Republican states.  Of the states who received a C or D rating, a state with less than 60% of hospitals with palliative care teams, 92% of those states voted Republican.  One state switches its votes.  No Democratic state received less than a B rating.

Here are the states and their rankings on % of hospitals with palliative care teams. https://reportcard.capc.org/

Reference

Chambers, B. (2020). How to increase awareness and reduce gaps in palliative care for minorities. Center to Advance Palliative Care. https://www.capc.org/blog/increasing-awareness-palliative-care-minorities/

Mayeda, D.P. & Ward, K.T. (2019). Methods for overcoming barriers in palliative care for ethnic/racial minorities: a systematic review. Palliative and Supportive Care. 17, 697–706.

Morrison, R. S. & Meier, D. E. (2019). A state-by-state report card on access to palliative care in our nation's hospitals. Center to Advance Palliative Care. https://reportcard.capc.org/wp-content/uploads/2020/05/CAPC_State-by-State-Report-Card_051120.pdf.

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