The Palliative Care Information Act and Access to Palliative Care in Terminally ill Patients: A Retrospective Study.
BACKGROUND
Studies have shown that over 50% of end-of-life discussions take place for the first time in the hospital and that terminally ill patients often have unrealistic views regarding the possible scope of treatment. The Palliative Care information Act (PCIA) was passed in an attempt to address the lack of access for terminally ill patients to palliative care services. A multi-database systematic review was performed on published studies from 2010 to present, and there were none found measuring the effectiveness of the PCIA.


OBJECTIVE
We aimed to study the effect of the PCIA on access to palliative care services.


METHODS
We conducted a retrospective chart review of all terminally ill patients who died at Kingsbrook Jewish Medical Center from January 2010 to August 2013 in relation to passing of the PCIA.


RESULTS
Prelaw (prior to the law passing), 12.3% of the terminal patients received palliative care consults, 25% during the transition period (time between passing of law and when it came into effect) and 37.7% postlaw (after coming into effect) (P< 0.001).


CONCLUSIONS
Legislation can have a significant effect on terminally ill patient's access to palliative care services and can change the culture of a hospital to be more pro-palliative for the appropriate populations.
Department of Medicine, New York Methodist Hospital, Brooklyn, New York, USA.
Kitty
K
Victoria
Department of Palliative Care Services, Kingsbrook Jewish Hospital, Brooklyn, New York, USA.
Sarita
S
Patel
Access to palliative care in terminal patients; End-of-life care; New York Palliative Care Law; Palliative Care Access Act; Palliative Care Information Act