The growth of palliative care programs in United States hospitals.
BACKGROUND
Palliative care programs are becoming increasingly common in U.S. hospitals.


OBJECTIVE
To quantify the growth of hospital based palliative care programs from 2000-2003 and identify hospital characteristics associated with the development of a palliative care program.


METHODS
Data were obtained from the 2001-2004 American Hospital Association Annual Surveys which covered calendar years 2000-2003. We identified all programs that self-reported the presence of a hospital-owned palliative care program and acute medical and surgical beds. Multivariate logistic regression was used to identify characteristics significantly associated with the presence of a palliative care program in the 2003 survey data.


RESULTS
Overall, the number of programs increased linearly from 632 (15% of hospitals) in 2000 to 1027 (25% of hospitals) in 2003. Significant predictors associated with an increased likelihood of having a palliative care program included greater numbers of hospital beds and critical care beds, geographic region, and being an academic medical center. Compared to notfor- profit hospitals, VA hospitals were significantly more likely to have a palliative care program and city, county or state and for-profit hospitals were significantly less likely to have a program. Hospitals operated by the Catholic Church, and hospitals that owned their own hospice program were significantly more likely to have a palliative care program than non- Catholic Church-operated hospitals and hospitals without hospice programs respectively.


CONCLUSIONS
Our data suggest that although growth in palliative care programs has occurred throughout the nation's hospitals, larger hospitals, academic medical centers, not-for-profit hospitals, and VA hospitals are significantly more likely to develop a program compared to other hospitals.
Morrison
R Sean
RS
Hertzberg Palliative Care Institute of the Brookdale Department of Geriatrics and Center to Advance Palliative Care, Mount Sinai School of Medicine New York, New York 10029, USA. sean.morrison@mssm.edu
Maroney-Galin
Catherine
C
Kralovec
Peter D
PD
Meier
Diane E
DE
D003625:Data Collection; D006761:Hospitals; D006801:Humans; D010166:Palliative Care / Q000706:statistics & numerical data*; D014481:United States