Explained here are some of the terms used throughout this report, along with a few others you are likely to encounter in similar publications.
Allopathic medicine: Also known as “conventional medicine,” it is the system of medical practice that treats disease by using remedies that produce effects that are different from those produced by the disease under treatment. MDs practice allopathic medicine.
Hospice care: Care focused on relieving symptoms and supporting terminally ill patients who are no longer seeking curative or life-prolonging treatments and are expected to live for about six months or less. Hospice care provides palliative care, but emphasizes only care, not cure. It is a team-oriented approach to medical care, pain management and emotional and spiritual support. The Medicare hospice benefit is limited to those patients with a life expectancy of six months or less.
Hospital types:
For-profit hospitals are run by individuals, partnerships or corporations with 50 or more total facility beds.
Non-profit hospitals are not-for-profit institutions run by by individuals, partnerships or corporations with 50 or more total facility beds.
Public hospitals are not-for-profit institutions run by a state, county, city, joint city-county or hospital district or authority with 50 or more total facility beds. (In this report, nongovernment, not-for-profit hospitals, such as those run by church-affiliated institutions, were excluded from this category.)
Sole community provider (SCP) hospitals are those that receive special designation by Medicare because they are located more that 35 miles from other like hospitals, or they serve as the sole provider of health care services for a region due to limitations in local topography or prolonged severe weather conditions.
Large hospitals are those with 300 or more facility beds.
Mid-size hospitals are those with 50 or more, but less than 300 facility beds.
Small hospitals are those with fewer than 50 facility beds.
Hospitalist: A physician who specializes in the care of hospital patients.
Hospital palliative care program: An interdisciplinary medical team focused on symptom management, intensive patient-physician-family communication, clarifying goals of treatment and coordination of care across health care settings.
National Consensus Project for Quality Palliative Care (NCP): A national project that published formal definitions of palliative care in 2004 (Clinical Practice Guidelines for Quality Palliative Care). The guidelines were intended to direct the development and structure of both new and existing palliative care programs, establish uniform definitions of the essential elements of palliative care, establish national goals for access to palliative care, promote performance measurement and quality improvement initiatives in palliative care services, and foster continuity of palliative care across settings (including home, hospital and hospice). The guidelines are presented within eight defined domains of quality palliative care.
National Quality Forum (NQF): A framework for preferred practices for providing quality palliative care released in 2006. Practices are defined across the Institute of Medicine′s six dimensions of quality: safe, effective, timely, efficient, equitable, and patient-centered. The NQF Framework used the National Consensus Project for Quality Palliative Care′s clinical practice guidelines as a starting point for identifying expectations and best practices in palliative care.
Palliative care, palliative medicine: The medical subspecialty focused on relief of the pain and other symptoms of serious illness. The goal of palliative care is to maximize quality of life for both patients and their families. Palliative care can be provided at any point in an illness, often concurrently with curative or life-prolonging treatments.
Palliative care is not the same as hospice care, which focuses on terminally ill patients who are no longer pursuing curative or life-prolonging treatment.
The American Board of Medical Specialties approved palliative medicine as a new physician subspecialty in 2006. Ten specialty groups–anesthesiology, emergency medicine, family medicine, obstetrics and gynecology, internal medicine, pediatrics, physical medicine and rehabilitation, psychiatry and neurology, radiology, and surgery–currently endorse hospice and palliative medicine as a subspecialty of their fields. With this endorsement physicians now have the opportunity to pursue postgraduate subspecialty training in palliative care.
Palliative care team: An interdisciplinary medical team that includes physicians, nurses and social workers, and may also include chaplains, massage therapists, pharmacists, nutritionists and others. These teams specialize in the treatment of the pain and other symptoms of serious, complex illness; intensive patient-physician-family communication; clarification of goals of care; and coordination of care across multiple settings.
