2014 Market Data: The Hospital Perspective on Palliative Care

Tuesday, March 11th, 2014
This post was written by Patricia Donovan


The majority of palliative care consults take place in hospitals, according to 62 percent of respondents to HIN’s 2014 survey on Palliative Care, although many responding healthcare organizations are working to separate these consults from the hospital bedside. In the meantime, there were several key areas where hospitals and health systems, which comprised almost half of survey respondents, stood out in terms of how they conducted palliative care programs.

For example, when asked to identify candidates for palliative care, this sector was least likely to rely on a diagnosis set (27 percent within this sector, versus a high of 78 percent and a mean of 45 percent) and direct member/patient referrals (33 percent for this sector, versus a high of 78 percent within the health plan and an overall mean of 55 percent). When listing components of their palliative care programs, this sector was also least likely to include a patient/provider liaison (44 percent versus a high of 78 percent and a mean of 68 percent) and clinical assessment (71 percent versus a high of 89 percent and a mean of 82 percent).

The composition of this sector’s palliative care team also varied, starting with the presence of primary care physicians, or PCPs: (52 percent of hospital palliative care teams versus a high of 77 percent and a mean of 63 percent); oncologists (19 percent versus a high of 67 percent and mean of 31 percent); geriatricians (19 percent versus a high of 56 percent for case managers and a mean of 33 percent); and physical therapists (13 percent of hospitals versus a high of 67 percent and mean of 34 percent). However, this sector was most likely to have a nurse practitioner on board (62 percent versus a low of 11 percent for health plans and an overall mean of 43 percent).

The timing of palliative care consults has shifted over the years. This sector is most likely to conduct them during a hospital stay (85 percent, versus a low of 44 percent and mean of 60 percent) and the least likely to conduct them during a home visit (21 percent versus a high of 79 percent for home health agencies, not surprisingly, and a mean of 47 percent).

Where to administer palliative care has also shifted, and this sector was twice as likely to conduct it on an inpatient basis (94 percent) as home health agencies, at a low of 50 percent, and typically least likely to conduct it via telephonic visits (10 percent), one fourth as likely as health plans, at 44 percent.

Excerpted from: 2014 Healthcare Benchmarks: Palliative Care

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