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      Barriers to Access to Palliative Care

      review-article
      Author(s):
      Publication date (Electronic):
      Journal: Palliative Care
      Publisher: SAGE Publications
      Keywords: palliative care, health service delivery, models of care, barriers to care

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          Abstract

          Despite significant advances in understanding the benefits of early integration of palliative care with disease management, many people living with a chronic life-threatening illness either do not receive any palliative care service or receive services only in the last phase of their illness. In this article, I explore some of the reasons for failure to provide palliative care services and recommend some strategies to overcome these barriers, emphasizing the importance of describing palliative care accurately. I provide language which I hope will help health care professionals of all disciplines explain what palliative care has to offer and ensure wider access to palliative care, early in the course of their illness.

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          Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.

          Marie Bakitas, Tor Tosteson, Zhigang Li … (2015)
          Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use.
          Article 0 comments Cited 318 times – based on 0 reviews     Review now
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            The Growth of Palliative Care in U.S. Hospitals: A Status Report

            Tamara Dumanovsky, Rachel Augustin, Maggie Rogers … (2016)
            Abstract 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.
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              The Bow Tie Model of 21st Century Palliative Care

              Philippa Hawley (2014)
              Article 0 comments Cited 17 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Palliat Care
                Journal ID (iso-abbrev): Palliat Care
                Journal ID (publisher-id): Palliative Care: Research and Treatment
                Title: Palliative Care
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Electronic): 1178-2242
                Publication date Collection: 2017
                Publication date (Electronic): 20 February 2017
                Volume: 10
                Electronic Location Identifier: 1178224216688887
                Affiliations
                Pain & Symptom Management/Palliative Care Program, BC Cancer Agency, Vancouver, BC, Canada.
                Author notes
                CORRESPONDING AUTHOR: Pippa Hawley, BC Cancer Agency, 600 W 10th Ave, Vancouver, BC, V5Z 4E6, Canada. Email: PHawley@ 123456bccancer.bc.ca
                Article
                Publisher ID: 10.1177_1178224216688887
                DOI: 10.1177/1178224216688887
                PMC ID: 5398324
                PubMed ID: 28469439
                SO-VID: 624fc847-46d2-4026-9b85-1b35b351cf85
                Copyright © © The Author(s) 2017
                License:

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 30 November 2016
                Date accepted : 04 December 2016
                Categories
                Subject: Review

                Keywords: palliative care,health service delivery,models of care,barriers to care
                Data availability:
                Keywords: palliative care, health service delivery, models of care, barriers to care

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