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Palliative Care and Population Health Compliment Each Other


An article in JAMA explores ways that palliative care and population health, though they have different goals and foci, are areas of medicine that can help and support each other. Palliative care focuses on improving the quality of life for patients and their families. Population health “focuses on improving the health of populations, with a special emphasis on reducing disparities in health outcomes and improving the value of health care.” These areas overlap especially in caring for the needs of older, frailer patients with chronic, life-limiting conditions.

Dr. David Casarett, author of the article, “Why Population Health and Palliative Care Need Each Other,” notes that population health has gained increasing attention since it was included in the Affordable Care Act. Population health could be strengthened as a discipline by including elements of palliative care. Palliative care focuses on quality of life for the patient, symptom management, and support for the family. These foci coexist well with population health’s commitment to “reducing morbidity and avoiding mortality.” Palliative care’s encouragement of discussion and honesty about treatments at the end of life can also be helpful to population health management. Population health considers the social determinates of health and palliative care, and also looks at health in a social and psychoemotional context. Palliative care could “expand the reach of population health interventions beyond prevention of illness by developing strategies to improve well-being after an illness has occurred.”

Population health also has things to offer palliative care. Because of it’s holistic, community- wide lens, “a population health–based approach may offer novel strategies to meet patients’ and families’ needs without relying on the services of palliative care consultants.” This could mean training other professionals in palliative care or patient education. Population health also focuses on prevention, which might allow palliative care to begin to address patient’s needs earlier in the course of an illness.

“The goal of population-based palliative care,” says Casarett, “should be to promote optimal well-being in the face of serious, life-threatening illness for patients and their families.” In order for this to happen, it must show that it is financially a smart choice. Structures should be put in place to support palliative care in communities and populations. This includes things like laws encouraging advance care planning and POLSTs. Population-based palliative care could also “find innovative ways to change the culture of serious illness and end-of-life care.” This would lead to improved communication, better symptom management, and shared decision-making.

Source: (Journal of the American Medical Association, 05/12,