Hospital-Based Palliative Care Models: Advantages and Limitations

Abstract

Introduction: Palliative care provides interdisciplinary care focused on patient-centered outcomes such as quality of life, symptom burden, emotional well-being, and caregiver need. With the aging population and the prevalence of chronic diseases, the need for palliative care is increasing. Thus, the need to provide palliative care services at different levels of the health system, especially in hospitals, cannot be ignored. In this study, we intended to examine the types of hospital-based palliative care models and identify the disadvantages and advantages of each of those models. Methods: This study was conducted as a comprehensive review in 2019. The required data were collected through an advanced keyword search, including hospital-based palliative care, palliative care in hospital, inpatient palliative care, palliative care establishment, palliative care development,and palliative care models in English databases such as Web of Science, Science Direct, Scopus, and PubMed as well as Persian databases such as Magiran and SID from 2005-2020. Results: Out of 3877 sources, 164 related sources were selected. Generally, nine hospital-based palliative care models were identified, including outpatient palliative care clinic, palliative care consultation service, palliative care day-care service, dedicated inpatient palliative care unit, palliative care outreach/home-care service, Swing beds, integration with the emergency department, integration with the ICU, and the integrated model. Some benefits and limitations were identified for each of the Hospital-based palliative care models. Conclusion: All hospital-based palliative care identified models can help hospitals to strengthen the palliative care approach, but given the limited resources of each hospital, hospital officials must choose between them and develop the model at their hospital after modifying and adapting that to the existing culture, structure, and facilities.