Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Curr Opin Support Palliat Care. 2013 Jun;7(2):201-6. doi: 10.1097/SPC.0b013e32836103e5.
To summarize the current United States healthcare system and describe current models of palliative care delivery.
Palliative care services in the USA have been heavily influenced by the public-private fee-for-service reimbursement system. Hospice provides care for 46% of adults at the end-of-life under the Medicare hospice benefit. Palliative care teams in hospitals have rapidly expanded to provide care for seriously ill patients irrespective of prognosis. To date, over two-thirds of all hospitals and over 85% of mid to large size hospitals report a palliative care team. With the passage of the Patient Protection and Affordable Care Act of 2010, healthcare reform provides an opportunity for new models of care.
Palliative care services are well established within hospitals and hospice. Future work is needed to develop quality metrics, create care models that provide services in the community, and increase the palliative care workforce.
总结美国当前的医疗保健系统，并描述当前的姑息治疗提供模式。
美国的姑息治疗服务深受公私收费服务报销系统的影响。在医疗保险的临终关怀福利下，临终关怀为 46%的成年人提供临终关怀。医院的姑息治疗团队迅速扩大，为无论预后如何的重病患者提供治疗。迄今为止，超过三分之二的医院和超过 85%的中型到大型医院都报告有姑息治疗团队。随着 2010 年《患者保护与平价医疗法案》的通过，医疗改革为新的护理模式提供了机会。
姑息治疗服务在医院和临终关怀机构中已经建立。未来需要开展工作来制定质量指标，创建在社区提供服务的护理模式，并增加姑息治疗人员。
