Where you live matters when you're seriously ill

October 2, 2008

America does a mediocre job caring for its sickest people. The nation, says a new report, gets a C.

Palliative care programs make patients facing serious and chronic illness more comfortable by alleviating their pain and symptoms and counseling patients and their families.

Only Vermont, Montana and New Hampshire earned an A, according to America's Care of Serious Illness: A State-by-State Report Card on Access to Palliative Care in Our Nation's Hospitals, a report based on a study in the October 2008 issue of the Journal of Palliative Medicine. Three states – Oklahoma, Alabama and Mississippi – got an F.

"The good news is that hospitals nationwide have implemented palliative care programs quickly over the last six years," said R. Sean Morrison, MD, director of the non-profit National Palliative Care Research Center and senior author of the study. "The bad news is that if you live in the South or you have to rely on public or small community hospitals, you're in trouble."

Ninety million Americans are living with serious illnesses such as cancer, heart disease, diabetes, Parkinson's, stroke and Alzheimer's. As the baby boomers age, this number will more than double over the next 25 years.

"Americans are living longer – but with serious illnesses," said Dr. Diane E. Meier, director of the Center to Advance Palliative Care and co-author of the study. "Without palliative care, people with serious illnesses like cancer often suffer unnecessarily from severe fatigue, pain, shortness of breath, nausea and other symptoms from their disease and treatments."

The study suggests that in states with more palliative care programs, patients are less likely to die in the hospital; don't have to go to the intensive care unit as much in the last six months of life; and spend fewer days in intensive care or the coronary unit in the last six months.

That also saves hospitals money, which could help lower health care costs.

Source: The Mount Sinai Hospital