Trinity College of Arts and Sciences, Duke University, Durham, North Carolina.
University of North Carolina, Chapel Hill, North Carolina.
J Pain Symptom Manage. 2021 Jul;62(1):149-152. doi: 10.1016/j.jpainsymman.2021.02.013. Epub 2021 Feb 17.
Increasing evidence has shown that access to specialty palliative care, particularly outpatient palliative care clinics, can yield improved health outcomes and be a marker of hospital quality.
To determine whether an association exists between access to specialty palliative care programs and hospital rankings found in the 2020-2021 U.S. News & World Report Best Hospitals.
This study used publicly available data from the Center to Advance Palliative Care (CAPC) Provider Directory to determine access to in-patient and out-patient palliative care in the 2020-2021 U.S. News & World Report Best Hospitals Rankings. Descriptive statistics and chi-squares were performed. Data were also analyzed across the four U.S. Census Bureau regions (Northeast, South, Midwest, West).
Around 100% of the Top 20 hospitals include hospital-based palliative care consultation teams, and 95% offered outpatient palliative care. Of the second cohort of 83 hospitals, 99% offered inpatient palliative care, and 65% offered outpatient palliative care. Of the third cohort of 75 hospitals ranked, 96% had inpatient palliative care services, while only 41.3% offered outpatient palliative care. This represents a significant association between rank position and access to outpatient palliative care (P < 0.01). Ranked hospitals also have significantly higher access to hospital-based palliative care teams compared to the national prevalence rate (P < 0.01).
These findings reflect the association of access to specialty palliative care with USNWR rankings for hospital quality. Further study is necessary to determine the specific influence of access to palliative care and USNWR rank position.
越来越多的证据表明，获得专科姑息治疗，特别是门诊姑息治疗诊所，可以改善健康结果，并成为医院质量的标志。
确定是否存在与专科姑息治疗项目的获得有关的关联，以及 2020-2021 年美国新闻与世界报道最佳医院中的医院排名。
本研究使用来自推进姑息治疗中心（CAPC）提供者名录的公开可用数据，确定了 2020-2021 年美国新闻与世界报道最佳医院排名中住院和门诊姑息治疗的获得情况。进行了描述性统计和卡方检验。还按美国人口普查局的四个地区（东北部、南部、中西部、西部）进行了数据分析。
前 20 名医院中约有 100%设有医院姑息治疗咨询团队，95%提供门诊姑息治疗。在 83 家第二队列医院中，99%提供住院姑息治疗，65%提供门诊姑息治疗。在排名第 75 的第三队列医院中，96%有住院姑息治疗服务，而只有 41.3%提供门诊姑息治疗。这表明排名位置与获得门诊姑息治疗之间存在显著关联（P < 0.01）。排名医院也比全国患病率更有机会获得基于医院的姑息治疗团队（P < 0.01）。
这些发现反映了获得专科姑息治疗与美国新闻与世界报道医院质量排名之间的关联。需要进一步研究以确定姑息治疗的获得和 USNWR 排名位置的具体影响。
