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Dying in California: A Status Report on End-of-Life Care

Kelley Queale and Kate Meyers

This status report describes California's progress over the past decade in end-of-life care, as measured against the Institute of Medicine's 2014 recommendations, and looks at the challenges that remain.

Dying in California serves as a snapshot of the state's progress in end-of-life care, as measured against the recommendations made in the Institute of Medicine's influential 2014 report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Dying in California was prepared by the Coalition for Compassionate Care of California.

Based on research and conversations with leaders in the field, as well as an online survey with experts in palliative care and advance care planning, Dying in California examines the state's progress in five areas: delivery of care, clinician-patient communication and advance care planning, professional education and development, policies and payment systems, and public education and engagement.

Overall, California has made progress toward improving care at the end of life. A wide variety of stakeholders have come together to support policy reform, outreach, education, and services. State government also has brought together key players to develop new programs and policies that support palliative care.

However, significant challenges remain. The growing need for palliative care far outpaces the capacity of services in California. In particular, palliative care specialists are in short supply, and certification programs are limited. Reliable funding streams do not yet exist. While knowledge is growing about best practices and quality standards, they have not yet been broadly implemented. And so far, consumer demand for better care at the end of life has not created the type of powerful change seen with the experience of childbirth.

The complete report is available as a Document Download.

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