Palliative Care at the Doorstep: A Community-Based Model

Palliative care is a growing specialty striving to improve quality of life in patients and families facing advanced illness, with demonstrated benefits. Outcomes regarding patients receiving community-based palliative care have not been extensively studied, with most focusing on patients with advanced cancer diagnoses. This article describes a community-based palliative care program, developed to provide care to patients with advanced illness. The mission, model of care, and program evolution are outlined; patient demographics, care settings, and comorbid diseases are reported. The average and median lengths of stay for patients who eventually transitioned to hospice care from 2012 to 2015 are compared with the affiliated hospice's total population and with national averages. Patients receiving community-based palliative care for a diagnosis of advanced illnesses who later transitioned to hospice had an increased median and total length of hospice stay as compared with other hospice referral sources and with national averages. For patients with advanced illnesses of many types, palliative care provided in the community setting may lead to earlier identification and referral to hospice as opposed to patients not receiving palliative care, with greater support at end of life.