University of Texas Southwestern School of Medicine, Dallas, TX, USA.
Division of Geriatrics, University of California, San Francisco, CA, USA; San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA.
J Am Med Dir Assoc. 2021 Oct;22(10):2207-2211. doi: 10.1016/j.jamda.2021.04.007. Epub 2021 May 7.
To determine the availability of palliative care programs in long-term acute care hospitals (LTACHs) DESIGN: Cross-sectional analysis using the 2016 American Hospital Association (AHA) Annual Survey.
LTACHs in the United States.
We used descriptive analyses to compare the prevalence of palliative care programs in LTACHs across the United States in 2016. For LTACHs without a program, we also examined palliative care physician capacity in regions where those LTACHs resided to evaluate if expertise existed in those regions.
One-third (36.5%) of 405 LTACHs (50.6% response rate) self-reported having a palliative care program. Among LTACHs without palliative care, 42.4% were in regions with the highest palliative care physician capacity nationwide.
LTACHs care for patients with serious and prolonged illnesses, many of whom would benefit from palliative care. Despite this, our study finds that specialty palliative care is limited in LTACHs. The limited palliative care availability in LTACHs is mismatched with the needs of this seriously ill population. Greater focus on increasing palliative care in LTACHs is essential and may be feasible as 40% of LTACHs without a palliative care program were located in regions with the highest palliative care physician capacity.
确定长期急性护理医院（LTACH）中姑息治疗计划的可及性。
使用 2016 年美国医院协会（AHA）年度调查进行横断面分析。
美国的 LTACH。
我们使用描述性分析比较了 2016 年美国 LTACH 中姑息治疗计划的流行率。对于没有计划的 LTACH，我们还检查了这些 LTACH 所在地区的姑息治疗医师的能力，以评估这些地区是否存在专业知识。
在 405 家 LTACH 中，有三分之一（36.5%）（50.6%的回复率）自我报告有姑息治疗计划。在没有姑息治疗的 LTACH 中，42.4%位于全国姑息治疗医师能力最高的地区。
LTACH 护理患有严重和长期疾病的患者，其中许多患者将受益于姑息治疗。尽管如此，我们的研究发现，专业姑息治疗在 LTACH 中受到限制。LTACH 中姑息治疗的可用性有限，与这一重病患者群体的需求不匹配。更加关注增加 LTACH 中的姑息治疗至关重要，并且可能是可行的，因为 40%没有姑息治疗计划的 LTACH 位于姑息治疗医师能力最高的地区。
