ABSTRACT
It is interesting that most studies of effectiveness to date have looked at cost rather than clinical outcomes. Cost-effectiveness has been a major variable in studies in an effort to preserve funding and expand coverage for hospice care. Hospice and palliative care are not that inexpensive to provide, and we certainly don't want palliative care that is weak or substandard. For a hospice program to survive in the current health care climate, it is essential that the program continually strive to reinvent itself and to learn from its experiences how to survive and thrive in its environment. As important as internal growth and change are, it is how a hospice or palliative care service is externally evaluated that determines its success or failure. A patient evaluation of hospice and palliative care survey process is being developed through the National Hospice and Palliative Care Organization to obtain concurrent data on patients' experiences in hospice.
