• Stephen R Connor.
• Research and International Development, National Hospice and Palliative Care Organization, Alexandria, Virginia 22039, USA. sconnor@nhpco.org
• J Pain Symptom Manage. 2009 Jul 1; 38 (1): 105-9.

AbstractThe remarkable growth of palliative care in the United States in the last 25 years has been fueled by the expansion of Medicare to include a hospice benefit. Medicare provides health insurance for qualified elderly individuals and Medicaid covers the poor. Hospice benefits are the same for both Medicare and Medicaid. Over one million elderly Americans make use of this benefit annually. Private insurers often mirror the Medicare benefit. Increasingly, hospice patients in the United States are patients with diagnoses other than cancer. Although national average length of service has increased to over two months, median length of service has declined to 20 days, with both more long- and short-term periods of service. U.S. hospice care is predominantly care delivered in the place the patient calls home (95.6%). Although the hospice benefit has provided palliative care for more patients and families than any other country, the requirements for use have been found to be self-limiting.

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