Dartmouth Health Tackles Rural Hospice, Palliative Care Disparities
A new Dartmouth Health teaching model and the Dartmouth Health at Home program aim to close end-of-life care gaps for older adults in rural and remote communities.
Key Facts
- Affected providers
- Hospice
End-of-life care disparities are pronounced across rural and remote regions, often driven by insufficient clinical home-based resources, according to Dartmouth Health, which is seeking to address the barriers with a new scalable, research-backed teaching model.
Research published in JAMA Network Open by investigators at The Dartmouth Institute for Health Policy and Clinical Practice, the Geisel School of Medicine, and Dartmouth Hitchcock Medical Center found that roughly 23% of older adults in rural communities face barriers to home-based hospice care, such as a lack of unpaid family caregiving support.
The identified barriers include a lack of clinical home-based resources, unreliable patient transportation, long travel distances and difficult terrain for clinicians, and additional time and cost that can make rural care financially unsustainable for providers.
The initiative ties into Dartmouth Health at Home, a home-based care program announced October 9 and supported by a $20 million philanthropic gift, which offers palliative and primary care and serves patients in New Hampshire and Vermont.
Tammy Tarsa, president and CEO of Dartmouth Health Home Care and co-CEO of Dartmouth Health at Home, said access requires a workforce and reimbursement system that recognize the realities of rural care, including the additional mileage, travel time, and staffing needs.
Dr. Jennifer Hunt, chief academic officer at Dartmouth Hitchcock Medical Center and dean of the Geisel School of Medicine, said the models are designed to be tested, implemented, and scaled nationally while training the next generation of clinicians for rural settings.
Sources & References
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