A large public hospital in Alabama implemented a house-call program that offers palliative care in rural communities. 

Background

Many small hospitals in Alabama do not offer palliative care, leaving rural residents who have a serious illness with few options for receiving needed symptom management and mental health services — often resulting in transfers to large hospitals far from a patient’s home. The University of Alabama at Birmingham (UAB) Hospital, one of the largest public hospitals in the U.S., serves many patients from rural areas. This case study features the UAB palliative care program, which uses home visits to reach patients in rural regions to provide symptom relief, counseling, and spiritual support.  

Findings

The case study features perspectives from clinicians, patients, and family members who have participated in the program. Key examples of how the program has been designed for rural patients include: 

• Using virtual consults to offer palliative care services through rural hospital; 

• Initiating services early in the disease progression; and 

• Creating an advisory group of Black pastors to ensure culturally competent care for Black patients. 

Program/Policy Takeaways

Palliative care programs in rural areas can leverage technology and home visits to address the needs of residents with serious illness.