National Hospice Work Group : Access To Hospice Care Report

Should access to hospice care be a social right in the United States? Is there equity in the distribution of hospice and palliative care health services? If not, what can be done to remove barriers to access?

The Hastings Center and the National Hospice Work Group [www.nhwg.org] in collaboration with the National Hospice and Palliative Care Organization [www.nhpco.org] have been collaborating on a project to improve access to quality end of life care. The "Hospice Access and Values" project has been examining how public policy and financing systems impede delivery of services that reflect the values of hospice and the preferences of the American public. The project team has completed an analysis of policy issues concerning access to humane and compassionate care at the end of life.

This review of hospice utilization and barriers to access should be required reading for all hospice administrators and anyone else concerned with either health care economics or social justice.

The introduction to this report states "The nation [the United States] has the technical expertise and financial resources to provide universal access to much higher-quality hospice care today. A just increase in access should take place principally in three ways: first, by making more people eligible for hospice admission and insurance coverage; second, by lengthening the average time spent in hospice, primarily through earlier referral; and third, by maintaining both high-quality care and good stewardship of scarce resources through a professionally rigorous case management system within hospice programs." Sections of the report cover specific challenges to access, the social marketing of hospice care, special issues for Alzheimer's Disease, and relevant public health policy questions.