Adoption and closure of hospital palliative care programs in the United States

In the United States, the percentage of hospitals over 50 beds with palliative care programs has risen substantially from 7% of hospitals in 2001 to 72% in 2017. But at the same time others may be closed. Adoption and closure of palliative care is investigated in the USA between 2009-2017.

All non-federal general medical and surgical, cancer, heart, and obstetric or gynaecological hospitals, of all sizes, in the United States in operation in both 2009 and 2017, are investigated.

By 2017, 35% of the hospitals without palliative care in 2009 had adopted palliative care programs, and 15% of the hospitals with programs had closed them. In multivariable models, hospitals in metropolitan areas, non-profit and public hospitals (compared to for-profit hospitals), and those with residency training approval by the Accreditation Council for Graduate Medical Education were significantly more likely to adopt and significantly less likely to close palliative care programs during the study period.

This study concludes that palliative care is not equitably adopted nor sustained by hospitals in the United States. Federal and state interventions are recommended to ensure that high-quality care is available to our nation’s sickest patients.      

See also: Rogers MM et al Factors Associated with the Adoption and Closure of Hospital Palliative Care Programs in the United States. Journal of Palliative Medicine.