The Growth of Palliative Care in U.S. Hospitals: A Status Report
| Autor: | R. Sean Morrison, Katrina Lettang, Rachel Augustin, Diane E. Meier, Tamara Dumanovsky, Maggie Rogers |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Palliative care MEDLINE Logistic regression Health Services Accessibility American Community Survey 03 medical and health sciences 0302 clinical medicine Health care Medicine Humans 030212 general & internal medicine Special Report General Nursing Geography Extramural business.industry Palliative Care General Medicine Census Status report Hospitals United States 3. Good health Anesthesiology and Pain Medicine Logistic Models Hospital Bed Capacity 030220 oncology & carcinogenesis Family medicine Female business Forecasting |
| Zdroj: | Journal of Palliative Medicine |
| ISSN: | 1557-7740 |
| Popis: | Background: Palliative care is expanding rapidly in the United States. Objective: To examine variation in access to hospital palliative care. Methods: Data were obtained from the American Hospital Association (AHA) Annual Surveys™ for Fiscal Years 2012 and 2013, the National Palliative Care Registry™, the Dartmouth Atlas of Healthcare, the American Census Bureau's American Community Survey (ACS), web searches, and telephone interviews of hospital administrators and program directors. Multivariable logistic regression was used to examine predictors of hospital palliative care programs. Results: Sixty-seven percent of hospitals with 50 or more total facility beds reported a palliative care program. Institutional characteristics were strongly associated with the presence of a hospital palliative care program. Ninety percent of hospitals with 300 beds or more were found to have palliative care programs as compared to 56% of hospitals with fewer than 300 beds. Tax status was also a significant predictor. Not-for-profit hospitals and public hospitals were, respectively, 4.8 times and 7.1 times more likely to have a palliative care program as compared to for-profit hospitals. Palliative care penetration was highest in the New England (88% of hospitals), Pacific (77% of hospitals), and mid-Atlantic (77% of hospitals) states and lowest in the west south central (43% of hospitals) and east south central (42% of hospitals) states. Conclusions: This study demonstrates continued steady growth in the number of hospital palliative care programs in the United States, with almost universal access to services in large U.S. hospitals and academic medical centers. Nevertheless access to palliative care remains uneven and depends on accidents of geography and hospital ownership. |
| Databáze: | OpenAIRE |
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