United States Ranks High in Palliative Care Access

The United States is in the top tier compared to other nations in terms of patient access to palliative care, though much of the country remains underserved despite rising demand.

Only 14% of the global population has access to palliative care at the highest level of provision, with the highest concentrations in European countries, according to a report published in the Journal of Pain and Symptom Management. Global demand for palliative care is expected to rise by 87% by 2060 due to the aging population and associated prevalence of chronic health conditions, the report indicated.

Researchers conducted an electronic survey of experts in 198 countries on 10 indicators of palliative care access. Of those, 30%, including the United States, were classified as having palliative care at an advanced state of integration, the highest level category used in the research. No access to palliative care was the lowest category, accounting for 24% of surveyed countries. The research relied on 2017 data.

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“The delivery of palliative care is seen increasingly as a global health issue. In 2014 the World Health Assembly passed a declaration calling upon all governments to integrate the provision of palliative care into their health plans,” the researchers wrote in the report. “There is growing evidence of the enormous need for palliative care that the world is facing. The burden of serious health-related suffering will almost double by 2060, with the fastest increases occurring in low-income countries, among older people, and people with dementia. Although it has become common to describe the need for global action to integrate palliative care into health systems as an ethical and economic imperative, palliative care development remains patchy, the field often lacks recognition, there is a dearth of investment, and research evidence to support its global growth is limited.”

Though the study found that the United States does well in comparison to other countries, access remains limited, largely due to lack of public awareness and a lack of a Medicare payment model.

The prevalence of hospital-based palliative care as grown in recent years, according to the Center To Advance Palliative Care. Currently 72% of hospitals in the United States with 50 or more beds have a palliative care program. This is up from 67% in 2015 and 7% in 2001. These institutions care for 87% of all hospitalized patients nationwide. Large nonprofit hospitals in large cities are the most likely to provide palliative care.

Patients in the northeastern United States who suffer from serious illness have significantly greater access to palliative care programs that individuals in other parts of the country.

However, few data are available to measure access to community-based palliative care delivered in patients’ homes.

Other research has found that close to 60% of patients in the United States who would benefit from palliative care do not receive those services, according to a report from the New England Journal of Medicine Catalyst Insights Council.

“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 NEJM 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.”