Models of non-hospice palliative care: a review

Ann Palliat Med. 2019 Feb;8(Suppl 1):S15-S21. doi: 10.21037/apm.2018.03.11. Epub 2018 Apr 25.

Abstract

Palliative care offers patients with a serious illness and their families access to services that can improve quality of life, mood, and symptoms. However, the term palliative care is often confused with end of life or hospice services limiting its application to persons with chronic illnesses who might benefit. Non-hospice palliative care is a term that is emerging to more accurately reflect the broader care model that palliative care represents. The aim of this review was to identify the characteristics of published nonhospice palliative care interventions. We derived our sample predominantly from a recently published systematic review and meta-analysis and selected studies published since the review. Inclusion criteria were: self-described palliative care intervention studies using randomized designs for participants with lifelimiting illnesses aged 18 years or older. These 38 studies fell into 3 broad categories: primary, specialty, and hybrid models. Common challenges among these models include limited education of generalists, limited reimbursement, and limited access in certain areas. However, increasing palliative care usage has also been associated with increased hospice use and appropriate timing of referrals.

Keywords: Non-hospice palliative care; generalist palliative care; primary palliative care; specialty palliative care.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Care / organization & administration
  • Facilities and Services Utilization
  • Home Care Services / organization & administration
  • Hospice Care / statistics & numerical data
  • Hospitalization
  • Humans
  • Middle Aged
  • Models, Organizational
  • Palliative Care / organization & administration*
  • Palliative Care / statistics & numerical data
  • Patient Care Team / organization & administration
  • Randomized Controlled Trials as Topic
  • Young Adult