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Rural Readmissions in the Palliative Care Vacuum

Durie, Craig, DNP, MSN, CRNP, ACHPN, RNFA, RN; Tanksley-Bowe, Catherine, DNP, MBA, MSN, CNM, RN

Journal of Hospice & Palliative Nursing: April 2018 - Volume 20 - Issue 2 - p 160–165
doi: 10.1097/NJH.0000000000000421
Feature Articles

Palliative care consultation is associated with reduced health care costs and improved quality of life while reducing length of stay. Small rural hospitals lack the depth of multidisciplinary resources to provide inpatient palliative care consult services. The purpose of this research was to assess the need for palliative care service in rural hospitals, while examining for a difference in hospital readmission rates in hospitals lacking palliative consult services. Data were obtained from the Pennsylvania Health Cost Containment Counsel including 3 hospitals with palliative programs and 3 without. Inclusion criteria were admissions for a patient carrying a diagnosis appropriate for palliative consultation between the last quarter of 2014 and 2015. There were 1394 index patients admitted to 3 rural hospitals lacking a palliative consult program. There was a higher rate of readmissions at the nonpalliative hospitals, 71.6% versus 55.1% (P < .001). Data suggest there is a need for palliative telemedicine services to meet needs in rural hospitals.

Craig Durie, DNP, MSN, CRNP, ACHPN, RNFA, RN, is nurse practitioner, OACIS Palliative Care, Lehigh Valley Hospital, Allentown, Pennsylvania.

Catherine Tanksley-Bowe, DNP, MBA, MSN, CNM, RN, is dean, university-wide program, and director of nursing, Stratford University, Falls Church; and acting director, Stratford University, Woodbridge, Virginia.

Address correspondence to Craig Durie, DNP, MSN, CRNP, ACHPN, RNFA, RN, OACIS Palliative Care, Lehigh Valley Hospital, 1255 S Cedar Crest Blvd, Ste 3500, Allentown, PA 18103 (

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© 2018 by The Hospice and Palliative Nurses Association.