U.S. Hospitals Fall Short On Palliative Care Staffing: Study

Only a quarter of all hospitals provide proper palliative care programs to patients with chronic and debilitating pain, according to the findings of a new study. 

Researchers with the Joint Commission found that only about one out of every four hospitals meet the Commission’s standard for palliative care. However, when unfunded programs were included, about 39% of programs met the standard.

The findings were published in the September issue of the journal Health Affairs.

Researchers analyzed data annual surveys of the National Palliative Care Registry. The registry took data from 410 hospital programs across the country from 2012 to 2013.

The Joint Commissions is a major accreditor of American hospitals and calls for hospitals that offer palliative care to include at least one physician, an advanced practice or registered nurse, social worker and a chaplain to patients.

Palliative care programs in hospitals provide care to seriously ill patients suffering from chronic and serious debilitating illness. It differs from hospice, in that it isn’t only for terminally ill patients.

Palliative care must provide paid teams including a doctor, a nurse, social worker and chaplain to help improve quality of life for patients and family caregivers. Things focused on in palliative care include pain, shortness of breath, fatigue, and depression. The teams also address emotional and spiritual needs and discuss end-of-life wishes.

The study found that half of hospitals failed to pay for a registered nurse or social worker. One-third of hospitals did not pay for a medical doctor or osteopath and two-thirds of programs did not provide a funded chaplain.

The research also indicated that in 2013, about 67% of hospitals with more than 50 beds had palliative care programs. In 1998 only 15% had those programs.

Larger palliative care programs are more likely than smaller ones to include a funded physician position. Yet, smaller palliative care programs are more dependent on advanced practice and registered nurses.

Researchers are calling for expanded and enhanced education concerning palliative care and financing methods to offer consultations for patients in need.

A study published in 2015 indicated millions of Americans needing palliative care who suffer from serious illness don’t have access to proper palliative care to help manage the illness and chronic pain.

Overall, palliative care was more common among not-for-profit and public hospitals than it was at for-profit hospitals.

It also indicated there were many regional differences as far as access to palliative care. About 88% of hospitals in the New England area had palliative care programs. This compares to about 77% of hospitals in the Pacific and mid-Atlantic regions and 40% of hospitals in the South-Central regions that have palliative care programs.

Research has shown palliative care has helped to improve patient outcomes and reduce medical costs, however many hospitals still refrain from implementing palliative care programs or properly instituting them.

Despite the research indicating the programs help patients and reduce costs, health insurers are slow to reimburse for them because the programs do not make hospitals profitable.