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More U.S. Hospitals Offer Palliative Care

Growth of specialty called a major change in U.S. health care

WEDNESDAY, Dec. 14, 2005 (HealthDay News) -- Palliative care programs are on the rise in U.S. hospitals, offering improved treatment for patients with advanced chronic and life-threatening illnesses, researchers report.

The number of hospitals offering palliative care programs has increased 63 percent in three years, from 632 hospitals in 2000 to 1,027 hospitals in 2003, according to the researchers at the American Hospital Association and Mount Sinai Medical Center in New York City.

"The medical community has begun to hear the needs of patients and families," said lead researcher Dr. Sean Morrison, vice chairman of research at Mount Sinai's department of geriatrics. "The specialty of palliative care is a response to that. And hospitals are beginning to embrace palliative care as part of their service delivery."

Palliative care is a medical specialty that focuses on improving quality of life for patients with advanced -- often life-threatening -- illness, Morrison said. "It does that through high-quality pain and symptom management, working with families and doing complex medical management and case management for patients and their families," he explained.

In their study, published in the December issue of the Journal of Palliative Medicine, the researchers used data from the American Hospital Association's Annual Survey of Hospitals 2005. Morrison's group discovered that palliative care programs are more likely to be found in hospitals in the Northeast, Pacific and Mountain regions than in other parts of the country.

In addition, larger hospitals, academic medical centers, not-for-profit hospitals and Veterans Administration hospitals are significantly more likely to offer palliative care, compared with city, county, state and for-profit hospitals.

The rapid growth in palliative care programs has been spurred by the increased numbers and costs associated with Medicare patients, the poor treatment of pain and other symptoms, a lack of coordinated care, and the hundreds of millions of dollars that have been invested in the growth of the field by the Robert Wood Johnson Foundation and others, the researchers reported.

"We know that palliative care programs are not only associated with better pain and symptom management, they are also associated with tremendous family satisfaction," Morrison said. "We are hoping that the growth will continue. It's our goal that in five years we will have almost all hospitals in the United States having a palliative care program."

One expert thinks palliative care is an important addition to medical care for the sickest patients.

"The growing availability of specialist-level palliative care is a major change now occurring in the U.S. health care system," said Dr. Russell K. Portenoy, chairman of the department of pain medicine and palliative care at Beth Israel Medical Center, in New York City.

Palliative care "strives to maintain quality of life throughout the course of disease and ensure that the end of life occurs with comfort, respect for dignity and autonomy, care for psychosocial and spiritual problems, and access to practical support," Portenoy said.

Palliative care should be part of the care offered by all clinicians who treat patients with life-threatening illnesses and available to all patients with advanced disease, he added.

"The population of the U.S. is aging, and chronic illness is highly prevalent. The change in health care reflected in this article is likely to have a significant impact on the quality and cost of care for many years to come," Portenoy added.

More information

To learn more, visit the National Hospice and Palliative Care Organization.

SOURCES: Sean Morrison, M.D., vice chairman of research, department of geriatrics, Mount Sinai Medical Center, New York City; Russell K. Portenoy, M.D., chairman, department of pain medicine and palliative care, Beth Israel Medical Center, and Chief Medical Officer, Continuum Hospice Care, and The Jacob Perlow Hospice Professor of Neurology and Anesthesiology, Albert Einstein College of Medicine, New York City; December 2005, Journal of Palliative Medicine
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