Description

Early implementation of specialized palliative care delivered in outpatient settings improved quality of life and mood of patients with advanced cancer. Despite rapid growth of specialized inpatient palliative care, much of the emerging evidence specific to hospital-based efforts is descriptive in nature, or methodologically flawed and heterogeneous in overall design. In an effort to create a comprehensive picture of the current state of hospital palliative care, the purpose of this review is to present recently published evidence unique to two primary models of hospital-based palliative care: palliative care consultation teams and traditional palliative care. PubMed and CINAHL were searched for research evidence related to inpatient specialized palliative care interventions published in the last five years (2006 to 2011). Randomized controlled trials (1), observational studies with comparison/control groups (15) and observational studies without comparison/control groups (21) are reviewed. Patient and family outcomes, length of stay, discharge disposition and costs associated were examined. Future expansion of inpatient palliative care into pediatric and emergency care areas is also addressed. Increased awareness of the movement towards palliative care in U.S. hospitals will eventually foster high quality studies such as the Randomized Controlled Trials conducted in the outpatient realm.

Key words: palliative care, inpatient, discharge disposition, hospital palliative care