Hospice and Palliative Care in The US Today
As of 2001, the hospice care industry in the US has grown to become a significant provider of end-of-life
care to Americans. Over 3,000 Hospice programs scattered across the nation care for some
700,000 patients per year (˜ 30% of Americans who die). 44% of hospice programs were independent,
freestanding organizations; 33% were hospital-based, 17% were home health agency based and 4%
were based in nursing homes or under other auspices as of 2001.
Over 700 of the 7,000 acute and an unknown number of the 17,000 long-term care institutions
provide some form of palliative care service to their clients today.
However data that describes their services, and their collective
effectiveness is not yet available.
Over the last 15 years, hospice growth has been considerable.
Refs:
1)
Facts and figures on Hospice Care in America, NHPCO, 2001
2) Pan CX, Morrison RS, Meier DE, Natale DK, Goldhirsch SL, Kralovec P, Cassel CK.
How prevalent are hospital-based palliative care programs? Status report and future directions.
J Palliat Med 2001 Fall;4(3):315-24.
Full Text
3)
Billings JA, Pantilat S.
Survey of palliative care programs in United States teaching hospitals.
J Palliat Med 2001 Fall;4(3):309-14.
Full Text
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CAPCManual Attribution:
von Gunten CF,
Ferris FD,
Portenoy RK,
Glajchen M, eds.
CAPCManual: How to Establish A Palliative Care Program.
New York, NY: Center to Advance Palliative Care, 2001.
©
Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, CA
and
The Department of Pain Medicine and Palliative Care, Beth Israel Medical Center, New York, NY, 2001
Permission to reproduce for non-commercial educational purposes with display of
attribution and
copyright is granted.
Last updated: February 20, 2002
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Rationale
Select section:
Changing Illness Experience
Changing Expectations and Needs
Progressive Healthcare Response
Responding to the Opportunity
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Changing Illness Experience
Illness in the Past
Progress Fighting Disaese
Illness Today
Prolonged Illness Experience
Chronic Disease Process
Determining Prognosis
Cancer
Manifestations
Predicament
Prolonged End-of-life Experience
Sudden Unexpected Death
Predictable Decline
Slow Decline, Multiple Acute Crises
Death in the US
Leading Causes of Death
Setting of Death
Desired
Reality
Multiple Issues Cause Suffering
The Square of Care
Morbidity
Pain
Need for Assistance
Social, Financial Impact
Implications for Care
Variable Need for Care
Opportunities
For Patients
For Families
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Changing Expectations and Needs
Increased Consumer Autonomy
Picker Institute 8 Dimensions of Care
Goals, Not Problems, Drive Care
Shift to Goal-oriented Care
Expect Competence, Expertise
Expect Comprehensive Assessment
Expect Effective Communication
Expect Participation in Decision-making
Expect Timely, Continous, Coordinated Care Delivery
Expect Assistance with Caregiving
Caregiver Training, Support
Caregiver Financial Support
Alternate Settings of Care
Respite Relief
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Progressive Healthcare Response
Focus on Disease-modifying Therapy
Focus on Care of the Dying
Early Hospice
Modern Hospice Movement
Dame Cicely Saunders
Origins of "Palliative Care”
Evolution of Hospice, Palliative Care
In United Kingdom
In Canada
In United States
Convergent Evolution
Hospice, Palliative Care in US Today
Hospice Growth
Continued Unmet Opportunity
A Public Health Issue
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Responding to the Opportunity
Paradigm Shift in Thinking
Provide Concurrent Care
Consider Application to Those at Risk
Expand Services, Settings of Care
1º, 2º, 3º Model of Delivery
Expand Access to Expertise
Create Specialized Environments
Many Names, Same Focus of Care
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