Expanding access to palliative care top goal.

By: Lori Earnshaw, MD, Turner West and Kristy Young

The need to improve serious illness care is particularly exigent in Kentucky because of our high prevalence of cancer and other serious illnesses and with the aging of the population.

The Center to Advance Palliative Care defines palliative care as specialized care for people living with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness—whatever the diagnosis.

The need to improve serious illness care is particularly exigent in Kentucky because of our high prevalence of cancer and other serious illnesses and with the aging of the population.

The goal is to improve quality of life  for both the patient and the family. Palliative care is provided by a team of palliative care doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness and can be provided along with curative treatment.

Healthcare expenditures in the United States are by no means equally distributed. One percent of the population accounts for over 20 percent of healthcare costs and five percent of the population for 50 percent of costs.

The population that disproportionately accounts for the majority of healthcare costs tends to be individuals living with serious illness who have multiple chronic conditions and limitations in function.

Despite the significant amount of healthcare resources used to serve this population, their experiences of care are perennially substandard. Individuals living with serious illness tend to experience a fragmented and confusing healthcare system, a high burden of pain and bothersome symptoms, a lack of attention to emotional and spiritual pain and poor communication from healthcare providers.

Top Legislative Priority
Numerous studies validate the value of palliative care for seriously ill individuals, their families, health systems, hospitals and payers. Additionally, because of the large body of evidence demonstrating the positive clinical outcomes associated with palliative care for people living with cancer, the American Cancer Society Cancer Action Network (ACS CAN) identifies expanding access to palliative care as a top legislative priority.

In 2017, ACS CAN and palliative care advocates asked lawmakers to support a bill that would have created a state-wide advisory council charged with advancing palliative care throughout  Kentucky, educational programming focused on palliative care principles, and a consumer guide for patients and families. Although the bill passed unanimously out of the Senate, it did not gain traction in the House of Representatives.

The need to improve care for the seriously ill has never been greater. Policy-makers, healthcare leaders and advocates should be considering palliative care as the solution for a better, more efficient healthcare delivery system in Kentucky.

— Lori Earnshaw, MD, is with Hosparus Health, Turner West is with Bluegrass Care Navigators and Kristy Young is with the American Cancer Society Cancer Action Network.