4112.0: Tuesday, October 23, 2001 - 1:15 PM

Abstract #26174

Community oriented palliative care: Early lessons from the Bronx

Francine Rainone, PhD, DO, Paul Meissner, MSPH, and Peter A Selwyn, MD, MPH. Department of Family Medicine and Community Health, Montefiore Medical Center, 3544 Jerome Avenue, Bronx, NY 10467

Demographic, medical, social and economic trends during the past half century have created a large aging and chronically ill population that no longer receives the bulk of its health care within institutions. There has been an increasing lay and professional concern with quality rather than quantity of life, and convincing evidence of deficits in the provision of effective palliative care services to patients with progressive incurable illness. Until now, palliative care has focused on people who are within weeks to months of death. It has been considered the default option when there is "nothing that can be done." Far from being "nothing," we maintain that curative treatment is incomplete and inadequate without concomitant palliation. We will present concrete strategies and case examples of how we are changing the culture and practice of medicine to reflect this expanded vision of palliative care. This presentation will describe the process of establishing a network of coordinated educational, service and outreach programs to improve the quality of and access to palliative care, as part of a demonstration project in community palliative care funded by the United Hospital Fund in New York City. We will provide details of establishing "Palliative Care Coordinators" at community-based primary care facilities, nursing homes, and in-patient and out-patient hospital-based primary care services. It will detail the criteria utilized to identify patients, the application of these criteria, and its results in identifying patients appropriate for palliative care. A demographic and health service utilization profile for patients receiving palliative care will be presented.

Learning Objectives: Participants will understand the process of integrating palliative care services across/among institutions and care settings. Participants will be come familiar with tools for identifying palliative care patients and tracking them as they move across different care settings.

Keywords: End-of-Life Care, Community Collaboration

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Montefiore Medical Center/Albert Einstein College of Medicine Bronx, New York 10467
Disclosure not received
Relationship: Not Received.

The 129th Annual Meeting of APHA