Report: 60% of Patients Needing Palliative Care Do Not Receive It

Close to 60% of patients who would benefit from palliative care do not receive those services, despite the availability of community-based palliative care as well as hospital-based palliative care, according to a new report from the New England Journal of Medicine Catalyst Insights Council. 

NEJM Catalyst is a think tank composed of health care executives, clinical leaders and frontline clinicians who develop innovations and practice applications to enhance the value of health care delivery and address the industry’s challenges. NEJM Catalyst’s Insights Council members participate in monthly surveys with specific health care topics.

“Palliative care helps patients live their best lives with the time they have left, and hospice care helps patients have the death they want consistent with their values,” co-author Amy Compton-Phillips, M.D., executive vice president and chief clinical officer at Providence St. Joseph Health in Seattle, said in the report. “Palliative care should be as ubiquitous as hospice care within the health care industry. If 60% of patients who would benefit aren’t receiving it, there’s a real disconnect.”

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Nearly all respondents to the NEJM Catalyst survey, 97%, reported that palliative and end-of-life care improves the patient experience; 94% indicated that palliative care improved the quality of care.

Lack of awareness is a major barrier to palliative care expansion. A Journal of Palliative Medicine study, published in April, found that as many as 71% of people in the United States have little to no understanding of what palliative care is, including many clinicians in a position to refer patients to palliative care or hospice.

In addition to the clinical benefits to patients, driving rising interest in palliative care is its potential for reducing health care costs. An analysis by economic research organization Florida TaxWatch found that palliative care could reduce societal health care costs by $103 billion within the next 20 years, the nonprofit economic research group Florida TaxWatch said in a report.

Palliative care saves state Medicaid programs an average of nearly $7,000 per patient annually, according to a 2011 study, particularly among those with serious illness or histories of hospitalization.

The survey found that nonprofit health care organizations are ahead of the game compared to for-profit providers. Nearly 60% of respondents from nonprofits indicated that their palliative care programs have existed for more than 6 years, compared to only 36% of respondents from the for-profit sector.

Alignment of payment incentives, including moving towards value-based health care, can help scale up palliative care services in the United States, the report suggested.

“The efforts of health care providers should be focused on improving access to these critical services for the patients who need them,” NEJM Catalyst Clinical Editor Namita Seth Mohta, M.D., said in the report.

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