Data Sources and Methodology

Data on hospital characteristics were obtained from the American Hospital Association (AHA) Annual Survey Database™ for the data year 2017 and supplemented with data from 2016 for non-responders. Additional data on hospital palliative care programs were obtained from the National Palliative Care Registry™ ( and CAPC’s Mapping Community Palliative Care initiative ( All hospitals identified as having palliative care programs but not participating in the Registry or Mapping were validated through existing databases, state palliative care directories, CAPC faculty, and web searches to verify reporting.

Analyses were limited to nongovernmental, general medical and surgical, children’s general medical and surgical, cancer, children’s cancer, heart, and obstetrics and gynecology hospitals within the fifty states and the District of Columbia. Analyses were also limited to hospitals that either responded to the AHA Annual Survey or participated in the Registry or Mapping initiatives. Where analyses are limited to hospitals with fifty or more beds, the final sample included a total of 2,409 hospitals. Of these, 2,348 completed the AHA survey; this number includes hospitals that also participated in the National Palliative Care Registry™ or CAPC’s Mapping Community Palliative Care initiative. An additional sixty-one hospitals that participated in the Registry but did not submit data to the AHA were also included.

Comparisons across Report Cards should be made with caution, as previous Report Cards did not include children’s general medical and surgical hospitals or children’s cancer hospitals. As with our previous Report Cards, the 2019 State-by-State Report Card did not examine timeliness, reach, or quality of hospital-based palliative care programs. The grades represented in the Report Card are based solely on the existence of palliative care teams in hospitals.

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Inquiries about A State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals should be directed to:

Rachael Heitner, MPH
Associate Director, Research and Insights
Center to Advance Palliative Care
[email protected]