Palliative care access varies by region despite benefits of cost and quality

Two years after the American Board of Medical Specialties officially recognized hospice and palliative care as a subspecialty, more than 1,200 U.S. hospitals have successfully implemented palliative care programs, but the services remain concentrated in certain regions, according to a new report.

Examining state-by-state access to palliative care—a treatment approach that involves comprehensive symptom management and care coordination for patients with serious and life-threatening conditions—the Center to Advance Palliative Care (CAPC) report card gives the nation a “C” grade for overall access to palliative care, noting wide geographic variation in the programs’ availability. After eight years of rapid growth in United States hospital palliative care programs, this report was undertaken in an effort to add to the literature on health care quality for seriously ill patients. The study focuses on geographic variations in access to hospital palliative care. Specifically, the authors examine

1. Patient access to palliative care services in hospitals

2. Patient access to board-certified palliative medicine physicians,

3. Medical student access to clinical training in palliative medicine,

4. Physician access to specialty-level training in palliative medicine

Despite robust growth in palliative care program prevalence in hospitals, there is much need for improvement if we are to adequately care for our sickest patients. Overall, our nation receives a grade of C. Almost half of the fifty states receive a “good” grade of either an A or B. However, almost 40 percent of states need significant improvement (C). More than 20 percent receive nonpassing grades of D and F. Only three states receive a grade of A.

Given palliative care programs’ potential to boost care quality, improve patient and family satisfaction, and reduce costs through thoughtful use of treatment resources, industry and hospital leaders are urging more consistent adoption

(SOURCES: HCPro Accreditation Connection,, November 3, 2008; Center for Medicare and Medicaid Services,, Accessed November 7, 2008)