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Innovations in End-of-Life Care
an international journal of leaders in end-of-life care

TABLE I:

Challenges for Hospice-Hospital Collaboration:
Different Cultures and Perceptions

Medicare Hospice Benefit	Palliative Care in Hospitals
Community-based	Teaching hospitals
Interdisciplinary teams	Doctor-centered teams
Home-centered	Hospital-centered
Whole person, family as unit of care model	Consultant and specialty ‘medical’ problem-based model
Cure-care dichotomy	Integration with curative treatments
Prognosis-dependent	Need-dependent
Standards, highly regulated	No standards
Established funding stream	No clear funding source
Established professional organization -power and lobbying base	Nascent professional organization - minimal power
Large clinical presence - 3,000 hospices, 50% of cancer deaths, 33% of predictable deaths	Small clinical presence - >400 hospitals have programs, 25% of teaching hospitals
Minimal academic presence	Increasing academic presence - 800+ ‘boarded’ MDs, 20 fellowships
Increasing service in long-term care	Little long-term care involvement

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Last Updated: February 22nd, 2002

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