Evaluation of a rural palliative care program shows promising impact on health outcomes and highlights implementation lessons.

Background

People living in rural areas often have less access to trained palliative care providers than their peers in urban communities. This evaluation assessed the impact of and lessons from the Stratis Health Rural Palliative Care Project — an initiative offering community-based palliative care in rural North Dakota, Washington State, and Wisconsin.

Findings

This mixed-methods evaluation used qualitative data (e.g. interviews, document reviews) and quantitative data (e.g. survey data, program-reported data) collected from 2019–2020 to assess the impact of a rural palliative care program and highlight implementation lessons. Patients experienced less inpatient and emergency department utilization in the two months post-enrollment, when compared to six months pre-enrollment (not tested for significance). Within a month of enrolling in palliative care, patients also reported reduced symptoms in seven of nine categories assessed. Providers also reported smoother patient transitions to hospice care because of the program.

The report also includes descriptive data on program implementation, such as program structure, care team structures, and extent to which sites achieved their program goals. Key implementation lessons include the need to: (1) educate communities and providers on palliative care, (2) maximize resources by building programs around existing resources/providers; and (3) develop sustainable financing.

Program/Policy Takeaways     

Palliative care programs show promise for improving health outcomes for people living in rural areas. Policymakers and organizations seeking to support implementation of rural palliative care programs may consider how to support provider education and sustainable financing.