Best Practices for Public Policies for Palliative Care Physical Therapy: A Critical Review of the Literature

Abstract

Background and Purpose: In comparison with the volume of patients living with a chronic disease or life-threatening illness, there remains insufficient availability and affordability of both palliative care (PC) and physical therapy (PT) services. The purpose of this critical review of the literature was to examine the factors impacting integration of PT within PC and identify opportunities to improve public policy initiatives to facilitate integration of PT and PC. Methods: Peer-reviewed articles regarding PT within PC as it relates to public policy and health care reform were retrieved through a critical review of the literature. Results: Twenty articles were identified and synthesized that described a variety of aspects of the effect of public policy and health care reform on the integration of PT and PC. Discussion: The evidence for the importance of PT in PC stems from multiple factors such as better symptom management, reduction in cost, decreased length of stay, fewer hospital readmissions, improved patient/provider satisfaction, and an increase in quality of life. Further integration of PT within PC and the associated benefits are heavily influenced by choices made in public policy. Conclusion: Public policies that should be addressed include regulation reform of payment and reimbursement, modernization of legislation for access and referrals to PT, institutional support of education for key PT and PC stakeholders, and increased funding for support of PT involvement in PC.