Palliative Care Challenges and Solutions in Rural U.S. Communities


  • Abstract

    Palliative care (PC) is interdisciplinary care to increase the comfort and quality of life for patients with serious illness, including providing physical, emotional, social, and spiritual care for patients and their caregivers. Rural patients face unique challenges PC, including traveling long distances to access care, lack of transportation, lack of PC health care professionals and resources, limited availability of PC, and cultural and social differences that may affect care. This study sought to describe the availability of PC services in rural communities compared to urban communities and identify novel solutions for providing this essential care to rural communities. This mix-methods study included an analysis of two surveys and qualitative interviews with administrators of small, rural hospitals that offered PC services.

    The study found that a  smaller proportion of rural hospitals (69.1%) vs. urban hospitals (75.9%) reported they provided PC services. PC services were inequitably distributed across rural counties according to socioeconomic and racial composition, with counties without PC services having higher poverty rates, lower levels of education, and higher proportions of Black and American Indian/Alaska Native populations. In the survey of rural hospitals, more than one-third (37.3%) reported that accessing PC services was somewhat or very difficult for patients in their communities. The most frequently reported barriers to providing PC services included dispersed geography (78.2%), inadequate PC workforce (73.0%), and inadequate PC workforce training (69.2%). Interviewees at small, rural hospitals reported that key facilitators for offering PC services included community collaboration, the availability of informal support networks, staff willingness to develop and employ innovative methods to deliver services, and affiliations with larger urban health care systems that can offer resources and support.


  • Authors:

    Oster NV, Baldwin LM, Justis P, Marchand L, Shearer J, Weng K, Patterson DG

  • Journal/Publisher:

    WWAMI Rural Health Research Center, University of Washington

  • Edition:

    Sep 2024.

  • Documents:

    Policy Brief

  • Citation:

    Oster NV, Baldwin LM, Justis P, Marchand L, Shearer J, Weng K, Patterson DG. Palliative Care Challenges and Solutions in Rural U.S. Communities. Policy Brief. WWAMI Rural Health Research Center, University of Washington; Sep 2024.

  • Related Studies:

    Palliative Care in the Rural U.S.