Where You Live Matters
Nation Improves but Regional Gaps Exist

Congress learned today just how well their home states are doing in terms of caring for our sickest Americans. According to a "Report Card" published by the Center to Advance Palliative Care, the nation overall gets a "B" grade, up from a "C," when the report was first released in 2008.

"The good news is that over the last ten years hospital palliative care teams have more than doubled," said Dr. Diane E. Meier, director of the Center and co-author of the study America's Care of Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals. "The bad news is that despite its enormous benefits to patients and care givers, millions of seriously ill Americans still do not have access to palliative care. Given the will of Congress to assure patients receive high quality care while reducing costs, it seems that palliative care should be a natural part of that prescription."

Palliative care is a medical specialty that helps people facing serious and chronic illness more comfortable by alleviating pain, treating a host of other symptoms and focusing on their quality of life. It is appropriate at any age and any stage of a serious illness and can be provided along with curative treatment. Approximately 90 million Americans are living with serious and chronic illnesses, such as cancer, heart disease, diabetes, Parkinson's, stroke, and Alzheimer's.

Findings from a separate 2011 Public Opinion Strategies survey found that most Americans believe palliative care should be made available at all hospitals. Once informed about it, 92% of respondents said they would consider it for a seriously ill loved one.

"America's hospitals have a strong history of caring for patients and families during the most difficult of times," said Rich Umbdenstock, President and CEO of the American Hospital Association. "Hospitals and other health care organizations are taking the lead in ensuring health care is patient-centered, reflecting patient's desires including palliative care assistance."

"Studies suggest that in states with more hospital-based palliative care programs, patients are less likely to die in the hospital, are likely to spend fewer days in the ICU, have better pain management and higher satisfaction with their healthcare," said Dr. Sean Morrison, director of the National Palliative Care Research Center and the study's lead author. "Some studies have reported that palliative care may also prolong life. And beyond patient benefits, the overall cost savings to hospitals have been well documented."

The Report Card demonstrates considerable improvement in the growth of palliative care. (Out of a total of 2,489 hospitals nationwide who participated in this survey, about 1,500 provide palliative care services.) This number is expected to grow significantly over the next five years, but barriers continue to exist in three key areas: Workforce, Research and Access.

The report gives seven states plus the District of Columbia an A: Maryland, Minnesota, Nebraska, Oregon, Rhode Island, Vermont and Washington. Only three states, Vermont, Montana and New Hampshire, received an A in 2008.

More than half of the fifty states received a grade of B. Seven states improved from a D to a C (Georgia, Kentucky, New Mexico, Texas, South Carolina, Louisiana and Wyoming).

Nevada saw dramatic gains, rising from a D to a B grade. Only two states – Delaware and Mississippi – got an F. Oklahoma, Alabama and Arkansas improved from an F in the last report card to a D in 2011.

For state and district rankings and policy recommendations visit www.capc.org/reportcard.

About CAPC and NPCRC

The Center to Advance Palliative Care (CAPC) (www.capc.org and www.getpalliativecare.org) and the National Palliative Care Research Center (NPCRC) (www.npcrc.org) are affiliated with Mount Sinai School of Medicine and are dedicated to increasing quality palliative care services for people facing serious illness.

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Contact: Sadia Choudhury, Center to Advance Palliative Care, Mount Sinai Medical Center 212-201-2673 or [email protected].

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