What Are the Models for Delivering Palliative Care in Rural Areas?

Palliative care and hospice services have evolved and matured mostly in urban areas alongside robust health infrastructures, with highly trained specialists and teams and other needed resources. Yet, nearly half of the world’s population resides in rural locales and experiences marked health disparities. Rural areas, geographically isolated with large distances between established communities, often have small populations and struggle to maintain primary care clinicians with limited to no access to specialty care such as palliative care. Collectively, although many rural communities share similar outcomes, rural regions often differ in population, infrastructure, and culture, with each area facing a distinct combination of challenges to delivering high-quality specialty palliative care. Several models for the delivery of rural palliative care services have been described and implemented; these include collaborative models, primary palliative care models, consultative and telehealth models, models that integrate lay navigators and family caregivers, and emergency palliative care models.