TY - JOUR T1 - Palliative medicine integration in the USA: cancer centre executives’ attitudes JF - BMJ Supportive & Palliative Care JO - BMJ Support Palliat Care DO - 10.1136/bmjspcare-2020-002835 SP - bmjspcare-2020-002835 AU - Joseph Chen AU - Allison de la Rosa AU - Dejian Lai AU - Rony Dev AU - Frances Lee Revere AU - David Lairson AU - Paige Wermuth AU - Eduardo Bruera AU - David Hui Y1 - 2021/04/11 UR - http://spcare.bmj.com/content/early/2021/04/11/bmjspcare-2020-002835.abstract N2 - Objectives To compare cancer centre (CC) executives’ attitudes towards palliative care between National Cancer Institute-designated CCs (NCI-CCs) and non-NCI-designated CCs (non-NCI-CCs) in 2018 and to examine the changes in attitudes and beliefs between 2009 and 2018.Methods CC chief executives at all NCI-CCs and a random sample of non-NCI-CCs were surveyed from April to August 2018. Twelve questions examined the executives’ attitudes towards palliative care integration, perceived barriers and self-assessments. The primary outcome was agreement on the statement ‘a stronger integration of palliative care services into oncology practice will benefit patients at my institution.’ Survey findings from 2018 were compared with data from 2009 to examine changes in attitudes.Results 52 of 77 (68%) NCI-CCs and 88 of 126 (70%) non-NCI-CCs responded to the survey. A vast majority of executives at NCI-CCs and non-NCI-CCs endorsed palliative care integration (89.7% vs 90.0%; p>0.999). NCI-CCs were more likely to endorse increasing funding for palliative care (52.5% vs 23.1%; p=0.01) and hiring physician specialists (70.0% vs 37.5%; p=0.004) than non-NCI-CCs. The top three perceived barriers among NCI-CCs and non-NCI-CCs were limited institutional budgets (57.9% vs 59.0%; p=0.92), poor reimbursements (55.3% vs 43.6%; p=0.31), and lack of adequately trained palliative care physicians and nurses (52.6% vs 43.6%; p=0.43). Both NCI-CCs and non-NCI-CCs favourably rated their palliative care services (89.7% vs 71.8%; p=0.04) with no major changes since 2009.Conclusion CC executives endorse integration of palliative care, with greater willingness to invest in palliative care among NCI-CCs. Resource limitation continues to be a major barrier.No data are available. ER -