National Scorecard Ranks Palliative Care Across Country

By<b>By Ed Edelson</b><br><i>HealthDay Reporter</i>
October 02, 2008, 1:56 PM

Oct. 3 -- THURSDAY, Oct. 2 (HealthDay News) -- There's a new medical specialty called palliative care, and it's become widespread enough to warrant a new state-by-state report card on its availability and quality.

"Palliative medicine is focused on improving the quality of life for patients with serious illnesses," said Dr. R. Sean Morrison, a professor of geriatrics and palliative care at Mount Sinai School of Medicine in New York and director of the nonprofit National Palliative Care Research Center, which issued the report card in the October issue of the Journal of Palliative Care..

Palliative care medicine "addresses the pain and other distressing symptoms of illness," Morrison said. "It also deals with the emotional and practical needs of patients and health-care providers. And it improves communication between patients and care providers."

The discipline was recognized as a specialty in Great Britain in 1987, said Dr. Porter Storey, executive vice president of the American Academy of Hospice and Palliative Medicine.

"It is now recognized by the American Board of Medical Specialities," he said. "But there have been palliative medical specialists working in the United States for over a decade. They do a lot of work in hospice programs, as well as hospitals."

In the new state-by-state ranking, only Vermont, Montana and New Hampshire get an A, while Oklahoma, Alabama and Mississippi get an F. The rest of the states are somewhere in between, although Southern states did not fare well in general.

"The marks are based on a research study we did, using data from the American Hospital Association and also data that we collected," Morrison said. "We gave letter grades based on the percentage of hospitals that had palliative care programs, appropriately set up to meet the needs of seriously ill patients."

There are 90 million Americans with conditions such as cancer, heart disease, Parkinson's disease and Alzheimer's disease who can benefit from such programs, according to the report, which shows a wide range of palliative care availability in different types of hospitals. Overall, 52.8 percent of American hospitals with more than 50 beds have palliative care programs. But such programs are found in only 20.3 percent of for-profit hospitals, 40.9 percent of publicly funded hospitals and 28.8 percent of hospitals that are sole community providers of medical care, the study found.

"Where you live often determines what kind of care you receive," Morrison said.

"I'm very glad to see that about half of the nation's hospitals have palliative care services, but I certainly wouldn't want to be a sick patient in a hospital that did not have such a service," Storey said. "Even five years ago, we didn't have anywhere near such services available, so the survey shows substantial growth, but the growth is very uneven."

One way to make the service more widely available is to lobby for it, Morrison said. "You can work with elected representatives to get state funding of palliative care team training. The study we did shows that doing so also lowers the cost."

On a more personal level, talking to a family physician before entering a hospital can help, Storey said. "A lot of patients have a choice about where to go," he said. "They can talk to the doctor about which hospitals have this service available. If physicians report to the hospitals that patients are looking for this service, the hospitals will pay attention."

More information

The state-by-state report card is available from the Center to Advance Palliative Care.

SOURCES: R. Sean Morrison, M.D., professor, geriatrics and palliative care, Mount Sinai School of Medicine, New York City; Porter Storey, M.D., executive vice president, American Academy of Hospice and Palliative Medicine, Chicago; October 2008, Journal of Palliative Medicine

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