In health care, as in so much of life, where you live matters. Understanding geographic variation in health care has long been a useful tool for targeting our attention and making improvements where we need them most.
Thanks to a report card released earlier this month by the Center to Advance Palliative Care (CAPC) and National Palliative Care Research Center, you can find out how well or poorly your state and geographic region is doing regarding equitable access to palliative care in hospitals. You can use this information to help advocate for better access in your state and at the national level.
We know that palliative care—specialized medical care for people living with serious illness that focuses on providing relief from the symptoms and stress of the illness—can greatly increase the quality of life for older adults and others with serious illness (it can extend life and is cost effective, too). We also know that access to palliative care services has grown tremendously over the past 15 years, thanks to the work of CAPC and other organizations.
The John A. Hartford Foundation has been a longtime supporter of the spread of high-quality palliative care through its funding of CAPC, and in the past two years has held two convenings related to palliative care—one in 2014 that brought together funders to explore ways to build the field and one earlier this year that gathered leading innovators in the field and funders with a deep interest in the topic specifically focused on end of life and serious illness.
Imagine if your parent or grandparent is living with cancer, congestive heart failure, or ALS and needs the pain and symptom management, spiritual care, and other services offered by specially trained palliative care teams. If they live in New England, which received an “A” rating, they have a great chance that any hospital they go to will have palliative care teams. If they live in Texas, like my parents, only 42 percent of the hospitals have these services.
Overall, states in the South received a grade of C (60 percent or fewer hospitals have palliative care teams) as compared to As and Bs (60 percent or more hospitals) for all other regions. States receiving a D grade (40 percent or fewer of hospitals having palliative care) were Alabama, Alaska, Arkansas, Mississippi, New Mexico, Oklahoma, and Wyoming.
Find out where you can access palliative care in your community.
Fortunately, there is also good news on many fronts. CAPC’s report card shows that 17 states received an “A” grade (80 percent or more hospitals have palliative care teams) and no state received an “F” (less than 20 percent). Ninety percent of all hospitals with more than 300 beds have palliative care teams (it’s the smaller hospitals where we have much room to grow) and 96 percent of teaching hospitals now have these teams, increasing the likelihood that the next generation of clinicians will receive training.
The report card, which has an accompanying article in the Journal of Palliative Medicine, goes beyond highlighting the successes and gaps in access and offers concrete policy recommendations for the federal government in three areas: workforce, research, and quality/payment. There are state policy recommendations, as well, that you can use to advocate for state task forces, quality standards, and training institutes if you live in one of the poorer-performing states.
While I am confident that following these recommendations with state and federal lawmakers will result in even more improvements in access to hospital-based palliative care, that will be just the starting point. The next frontier for palliative care is moving it upstream into primary care and into community settings where people living with long-term, serious chronic conditions can reap the benefits palliative care offers.
Someday, we will be grading our states on this level of palliative care access and hopefully, we will see A pluses across the country.
Join a free webinar briefing on Tuesday, Nov. 17, 2015, from 1:30-2:30 p.m. EST to learn more about the state-by-state report card.
This is the 15th in an occasional series. See other Health AGEnda posts on Tools You Can Use: