Availability of Palliative Care in Long-Term Acute Care Hospitals

Nathan Sumarsono; Rebecca L Sudore; Alexander K Smith; Steven Z Pantilat; Wendy G Anderson; Anil N Makam

doi:10.1016/j.jamda.2021.04.007

Availability of Palliative Care in Long-Term Acute Care Hospitals

J Am Med Dir Assoc. 2021 Oct;22(10):2207-2211. doi: 10.1016/j.jamda.2021.04.007. Epub 2021 May 7.

Authors

Nathan Sumarsono¹, Rebecca L Sudore², Alexander K Smith², Steven Z Pantilat³, Wendy G Anderson⁴, Anil N Makam⁵

Affiliations

¹ University of Texas Southwestern School of Medicine, Dallas, TX, USA.
² Division of Geriatrics, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
³ Division of Palliative Medicine, University of California, San Francisco, CA, USA.
⁴ Division of Hospital Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA; Supportive and Palliative Care Program, San Francisco General Hospital, University of California, San Francisco, CA, USA.
⁵ Division of Hospital Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, CA, USA. Electronic address: anil.makam@ucsf.edu.

Abstract

Objective: To determine the availability of palliative care programs in long-term acute care hospitals (LTACHs) DESIGN: Cross-sectional analysis using the 2016 American Hospital Association (AHA) Annual Survey.

Setting and participants: LTACHs in the United States.

Method: We used descriptive analyses to compare the prevalence of palliative care programs in LTACHs across the United States in 2016. For LTACHs without a program, we also examined palliative care physician capacity in regions where those LTACHs resided to evaluate if expertise existed in those regions.

Results: One-third (36.5%) of 405 LTACHs (50.6% response rate) self-reported having a palliative care program. Among LTACHs without palliative care, 42.4% were in regions with the highest palliative care physician capacity nationwide.

Conclusions and implications: LTACHs care for patients with serious and prolonged illnesses, many of whom would benefit from palliative care. Despite this, our study finds that specialty palliative care is limited in LTACHs. The limited palliative care availability in LTACHs is mismatched with the needs of this seriously ill population. Greater focus on increasing palliative care in LTACHs is essential and may be feasible as 40% of LTACHs without a palliative care program were located in regions with the highest palliative care physician capacity.

Keywords: LTACH; Long-term acute care; health policy; health services; palliative care.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Health Facilities
Hospitals*
Humans
Long-Term Care
Palliative Care*
United States

Abstract

Publication types

MeSH terms

Grants and funding