title: How well is palliative care integrated into cancer care? A MASCC, ESMO, and EAPC Project.
abstract: BACKGROUND
  The benefits of integration of palliative care into oncology have become evidence-based. How palliative care is perceived and structured in various settings and countries would be of interest.
  
  
  METHODS
  We used a previously published questionnaire to survey multiple institutions with members in MASCC and ESMO. The survey was made available on the MASCC website for approximately 6 months and repeated requests were made to complete the survey. Comparisons were made between NCI/ESMO designated cancer centers, nondesignated cancer centers, and urban hospitals.
  
  
  RESULTS
  One hundred eighty-three different institutions completed this survey, 28 % of ESMO designated centers. Most institutions had palliative care programs and most programs consisted of an inpatient consult service and outpatient clinics. A minority had inpatient palliative care beds and institution supported hospice services. Barriers to palliative care were largely financial. Integration of palliative care into oncology was highly desirable but only a minority of respondents felt that their institution would financially support expanded services and additional palliative care personnel. Designated centers were more likely to have expanded palliative care services.
  
  
  CONCLUSIONS
  Our findings are very similar to those previously published. Multiple studies have demonstrated that though palliative care integration into oncology is highly beneficial as measured by patient related outcomes, there is a great concern about reimbursement for services and budget constraints which prevent expansion of services.
  
  
  CONCLUSIONS
  Palliative care integration into cancer care is largely through consulting services for inpatients and outpatient clinics. Financial concerns limit integration and expansion of palliative care services. Designated cancer centers have more extensive palliative care services relative to nondesignated cancer centers and urban hospitals.
authors: Palliative Medicine and Supportive Oncology Services, Division of Solid Tumor, Taussig Cancer Institute, The Cleveland Clinic, Cleveland Clinic Lerner School of Medicine Case Western Reserve University, Cleveland, OH, USA, davism6@ccf.org.
authors: Mellar P
authors: MP
authors: Davis
authors: Florian
authors: F
authors: Strasser
authors: Nathan
authors: N
authors: Cherny
mesh_terms: D017051:Hospice Care; D006801:Humans; D008495:Medical Oncology / Q000379:methods* / Q000706:statistics & numerical data; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000379:methods* / Q000706:statistics & numerical data; D012017:Referral and Consultation; D011795:Surveys and Questionnaires