North Carolina gets B ranking for palliative care

North Carolina received today another "B" for the attention and resources it puts into palliative care. The ranking was provided by the Center to Advance Palliative Care, which is affiliated with Mount Sinai School of Medicine in New York. North Carolina got the same grade in the group's last ranking in 2008. Palliative caring is defined as a medical specialty that helps people facing serious and chronic illness be more comfortable through alleviating pain and symptoms and focusing on their quality of life. About 90 million Americans could benefit from palliative care, according to the center. Out of 2,489 hospitals nationwide who participated in this survey, about 1,500 provide palliative-care services. The national ranking rose from "C" to "B" in the past three years, according to a report released in the October issue of the Journal of Palliative Medicine. "The good news is that over the last 10 years, palliative-care teams have more than doubled," pronounced Dr. Diane Meier, director of the center and co-author of the study. "The bad news is that despite its enormous benefits to patients and caregivers, millions of seriously ill Americans still do not have access." Dr. Sean Morrison, director of the National Palliative Care Research Center and the study's lead author, pronounced patients benefiting from caring teams "are less likely to die in the hospital, are likely to spend fewer days in intensive-care units, have better pain management and higher satisfaction with their health care." "Some studies have reported that palliative caring may also prolong life. And beyond patient benefits, the overall cost savings to hospitals has been well documented." Dr. Laura Henson, with the UNC Hospital Palliative Care program, pronounced North Carolina has become more proactive about encouraging palliative caring teams. "Our grade corresponds to the presence of palliative-care services in 77 percent of hospitals across the state," Henson said. "Many of! the pro grams are represented in the national directory maintained by the Center to Advance Palliative Care and at www.getpalliativecare.org. "Many of these hospitals are providing generous financial support to ensure these new services can expand and be supported." Yet, Henson said, too many North Carolinians cannot find a palliative caring provider in their hospital or their county. "We need to expand the number of certified fellowships in hospice and palliative medicine across the state," Henson said. "Ideally, funding for these training positions coming from state resources would also encourage newly trained physicians to provide services in North Carolina following training. "Our state-level payers, such as Blue Cross and Blue Shield of N.C. or the state's Medicaid program, could initiate specific payment codes for palliative caring services by certified providers." Morrison pronounced palliative caring provides "a novel solution" to the health-care crisis. "Overwhelmingly, health-care costs are being driven by the inability of the current system to meet the needs of the seriously ill the 10 percent of the population that accounts for over 60 percent of costs," Morrison said. "Palliative-care teams help facilitate safe hospital discharges, reduce unnecessary hospitalization, help avoid unwanted and unnecessary burdensome treatments, and ensure that patients are cared for in the setting where they want to be, usually home." Morrison pronounced more physicians are needed to meet the expected surge in services as baby boomers retire and need more medical care. "For example, the ratio of oncologists to newly diagnosed cancer patients is on the order of 1 for every 150 patients," Morrison said. "The ratio of palliative medicine physicians to persons with serious illness is 1 to every 1,700 patients. "Currently, without leaving one's job for a year to complete fellowship training with 30-year-old newly trained doctors, there is no mechanism for mid-career physicians to cha! nge thei r career focus."