Palliative Care in Your State
There are at least 12 million adults and 400,000 children across the country living with a serious illness. For these high-need individuals, palliative care has been shown to improve quality of life and reduce caregiver burden, and in so doing, reduce avoidable utilization (e.g., emergency department visits, hospital and ICU stays).
This report—a complement to the 2019 State-by-State Report Card—provides information about palliative care access in your state, along with resources to improve it.
The availability of palliative care services in U.S. hospitals varies widely by state and region. The following table compares availability in your state to regional and national palliative care availability, broken out by hospital size.1 The majority of large hospitals—those with 300 or more beds—now report availability of palliative care. A much lower percentage of smaller hospitals report meeting the standard of a full palliative care interdisciplinary team due to resource constraints.2
Location | 2019 Grade* | By Hospital Size | |||
---|---|---|---|---|---|
< 50 beds | 50-150 beds | 151-299 beds | 300+ beds | ||
State | 77.3% B |
43.8% (14/32) |
55.9% (38/68) |
81.3% (65/80) |
93.1% (67/72) |
Region | 78.3% B |
45.7% (48/105) |
58.0% (65/112) |
85.0% (91/107) |
94.7% (89/94) |
National | 71.5% B |
36.3% (557/1535) |
51.1% (474/928) |
75.6% (578/765) |
93.7% (671/716) |
Hospital palliative care is most common in urban communities. The graph below (figure 1) compares hospital palliative care availability in your urban, suburban, and rural communities against the regional and national percentages, and includes hospitals of all sizes.1
The map below (figure 2) shows all California hospitals that report palliative care, and includes hospitals of all sizes.1 Solid dots indicate hospitals that report palliative care programs and empty dots indicate hospitals that do not currently offer palliative care.
The Center to Advance Palliative Care (CAPC) also collects information on palliative care programs serving patients in office practices, clinics, nursing homes, and/or home-based settings.
At least 95 programs providing palliative care in the community have been reported in your state.3 Visit GetPalliativeCare.org for information on palliative care programs that have chosen to participate in the Provider Directory.
Physicians, advanced practice registered nurses, registered nurses, social workers, and chaplains can all pursue specialty certification in palliative care. Not all who work on palliative care teams have received palliative care certification, and there may be some palliative care–certified clinicians who work in other capacities.
The graph below (figure 3) shows the numbers of MDs, APRNs, and RNs who have received specialty certification in palliative care or pediatric palliative care.4 A number of palliative care–certified doctors of osteopathy (DOs), social workers, and chaplains may be providing care in your state, but these numbers were either unavailable or too low to be included at the state level. Additional members of the palliative care interdisciplinary team include physician assistants, pharmacists, and other health professionals as needed, although specialty palliative care certification does not currently exist in these fields.
There are 2.8 certified prescribing palliative care providers (MDs or APRNs) per 100,000 residents in your state.5 This capacity is likely insufficient to meet the needs of your state. Building the skills of all clinicians caring for people with serious illness may be an important strategy to complement the specialty palliative care workforce.
In California, 148 organizations are currently members of the Center to Advance Palliative Care, and have access to tools, clinical and operations training, and technical assistance in support of high-quality palliative care services.
This means that thousands of health care clinicians already have access to training in communication skills, pain and symptom management, supporting family caregivers, and building new palliative care programs. Contact [email protected] to discuss how you can leverage these resources.
State champions can make a number of changes to advance palliative care access and quality in the areas of workforce, payment, clinician skill building, and public awareness. Examples of state initiatives include:
Palliative care leaders in this state may have more targeted recommendations to improve access and quality, and should be consulted before embarking on any new initiative. Visit CAPC’s State Policy Resources for more information and/or email [email protected] to join the State Palliative Care Forum.
This report was prepared on 12/13/2019. Some of the figures may use data from earlier years.
Inquiries about A State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals should be directed to:
Inquiries
Rachael Heitner, MPH
Associate Director, Research and Insights
Center to Advance Palliative Care
[email protected]
Inquiries about A State-by-State Report Card on Access to Palliative Care in Our Nation’s Hospitals should be directed to:
Inquiries
Rachael Heitner, MPH
Associate Director, Research and Insights
Center to Advance Palliative Care
[email protected]