Oncology Rounds

Support services insights: Palliative care utilization and referral patterns

by Ashley Riley

This is part of a weekly series on results from our 2015 national benchmarking survey on cancer program support services volumes, staffing, and operations. Make sure you’re subscribed to follow along.

Last week, we talked about the typical palliative care services offered and the corresponding staffing at organizations across the country. But how many cancer patients receive palliative care? And how are they referred to this service? Keep reading to find what our survey of more than 150 organizations revealed.

Significant portion of patients receiving palliative care have cancer, but utilization still low

95% of survey respondents indicated that their organization offers some type of palliative care service, including a dedicated inpatient unit, inpatient consult service, outpatient clinic, or home-based program.

Among organizations that offer palliative care services, more than one-third of patients receiving palliative care were cancer patients (35%). However, when asked what percentage of the program’s cancer patients receives palliative care, we found that, on average, less than one-fifth of cancer patients received these services (15%). This indicates that palliative care is still underutilized by cancer patients—many of whom could benefit from these services.

Organizations would benefit from standardizing referral criteria

The majority of cancer programs leave patient referral to palliative care up to the discretion of the treating physician. Only about a quarter of facilities automatically refer cancer patients with late-stage diagnoses and/or metastatic solid tumors, and even fewer automatically refer patients with uncontrolled pain or symptoms. Almost no programs refer all cancer patients upon diagnosis.

Without clear referral triggers to palliative care, many cancer patients are missing out on a service that can significantly improve their quality of life and even their outcomes. Check out how Mount Sinai improved use of palliative care—resulting in deceased readmissions and increased use of hospice.

How to capture the value of palliative care

We identified five characteristics of the most effective palliative care programs to help your organization implement an initiative that will yield longer survival rates, lower costs, and improved quality.