Nurse practitioner-based models of specialist palliative care at home: sustainability and evaluation of feasibility.

Context: Patients with serious medical problems who live at home may not be able to access specialist-level palliative care when the need develops. Nurse practitioner (NP)-based models may be able to increase the availability of specialist care in the community.

Objectives: The aim of this study was to evaluate the financial sustainability and feasibility of two NP-based models in an urban setting.

A review of barriers to utilization of the medicare hospice benefits in urban populations and strategies for enhanced access.

Disparities in access to health care extend to end-of-life care. Lack of access to hospice mirrors lack of access to health maintenance and primary care. Patients who are served by hospice nationally are disproportionately white and likely to reside in economically stable communities.