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When Palliative Care Is the Best Care

Growing subspecialty saves money, lengthens lives (December 3)

According to a report from the Kaiser Family Foundation, hospitals around the country are increasingly starting palliative care programs designed to relieve seriously ill patients’ pain, stress, and symptoms regardless of how long they have to live. While some patients are close to death, others are still receiving treatment to extend their days. And as they do, palliative care teams, including doctors, social workers, nurses, and chaplains, try to improve their quality of life.

Palliative care teams help manage symptoms such as nausea, difficulty sleeping, and fatigue, and they coordinate with the doctors providing treatment. They also provide patients and families with emotional and spiritual support, helping them understand the illness and guiding them through difficult treatment choices.

More than two-thirds of hospitals with more than 50 beds offer palliative care, up from 25% in 2000, according to the Center to Advance Palliative Care at Mount Sinai School of Medicine. Washington is a leader in the field; more than 80% of hospitals have such programs. The field is recognized as a subspecialty, and there are fellowships, journals, and research centers devoted to the topic.

But some doctors are resistant to palliative care because they believe it pushes patients away from medical treatment that could help them fight their illnesses.

Even the idea of patients planning ahead and making decisions about their care has caused controversy. A provision that would have paid doctors for having discussions about living wills with their patients was taken out of the Patient Protection and Affordable Care Act (PPACA) after conservatives raised concerns over “death panels.” An Oregon congressman is trying to revive that discussion with a similar proposal.

Regardless of what happens with the legislation, experts say palliative care programs will continue to grow as baby boomers age and as hospitals look for ways to reduce costs and increase value under the PPACA. Studies show that palliative care reduces health care spending by avoiding unnecessary treatment and by getting patients out of the hospital faster. Researchers have also concluded that palliative care improves patient satisfaction and lengthens life.

Source: Kaiser Health News; December 3, 2013.

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