Palliative care services in Pennsylvania nursing homes.
BACKGROUND
Palliative care is an interdisciplinary model that focuses on the comprehensive management of physical, psychological, social, and spiritual needs of individuals with lifelimiting illness. Although palliative care is increasingly common in acute care settings, regulatory, financial, and educational barriers often bar nursing home residents from access to palliative care services.


OBJECTIVE
The purpose of the Palliative Care Services in Pennsylvania Nursing Homes Survey was to describe existing palliative care services within nursing homes in Pennsylvania, and to classify these services by level of care delivery.


METHODS
Ninety-one nursing home administrators throughout the state of Pennsylvania participated in the mailed survey. Multiple logistic regression analysis was used to investigate the association between various organizational characteristics and provision of palliative care services.


RESULTS
Results reveal that urban facilities were more likely to provide palliative care services than rural facilities. Urban facilities cited the need for bereavement training most frequently, whereas rural clinical cited the need for training in pain management. Larger facility size was associated with an increased likelihood of pain management practices, even after adjusting for regional differences.


CONCLUSIONS
These pilot findings are consistent with and extend previous findings suggesting that palliative care practice in nursing homes is strongly influenced by nonclinical factors and invites further investigation.
Hodgson
Nancy
N
Polisher Research Institute, North Wales, Pennsylvania 19454, USA. nhodgson@abramsoncenter.org
Landsberg
Lisa
L
Lehning
Amanda
A
Kleban
Mort
M
D019538:Health Care Surveys; D006801:Humans; D009735:Nursing Homes / Q000458:organization & administration; D010166:Palliative Care / Q000706:statistics & numerical data*; D010414:Pennsylvania