BACKGROUND: Palliative care is an interdisciplinary model that focuses on the comprehensive management of physical, psychological, social, and spiritual needs of individuals with lifelimiting illness. Although palliative care is increasingly common in acute care settings, regulatory, financial, and educational barriers often bar nursing home residents from access to palliative care services. OBJECTIVE: The purpose of the Palliative Care Services in Pennsylvania Nursing Homes Survey was to describe existing palliative care services within nursing homes in Pennsylvania, and to classify these services by level of care delivery. METHODS: Ninety-one nursing home administrators throughout the state of Pennsylvania participated in the mailed survey. Multiple logistic regression analysis was used to investigate the association between various organizational characteristics and provision of palliative care services. RESULTS: Results reveal that urban facilities were more likely to provide palliative care services than rural facilities. Urban facilities cited the need for bereavement training most frequently, whereas rural clinical cited the need for training in pain management. Larger facility size was associated with an increased likelihood of pain management practices, even after adjusting for regional differences. CONCLUSIONS: These pilot findings are consistent with and extend previous findings suggesting that palliative care practice in nursing homes is strongly influenced by nonclinical factors and invites further investigation.
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Hodgson et al. (2006) studied this question.