Abstract：
BACKGROUND: Palliative care (PC) played a leading role in the COVID-19 pandemic. However, little is known regarding health system leadership\'s perceptions.
BACKGROUND: This study aimed to explore the perceptions, understanding, and utilization of PC before compared to during the COVID-19 pandemic among health system leadership.
METHODS: Semi-structured, in-depth interviews were conducted with leaders in a large healthcare system based in Massachusetts, United States.
RESULTS: A total of 22 in-depth interviews were completed at four facilities. Emerging themes included the role of PC before compared to during the COVID-19 pandemic, facilitators and barriers to PC delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased PC utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found PC financing to be a barrier to delivery; some had an inaccurate understanding of how PC is reimbursed. When asked about their recommendations for improving future practice, participants noted improvements in coordination within the healthcare system and education of healthcare providers and future physicians in primary PC skills.
CONCLUSIONS: Our findings suggest that healthcare leadership increasingly understands the value of PC and its critical role within the health system and during future public health emergencies; this was further reinforced during the COVID-19 pandemic. Healthcare leadership recognizes and highlights the need to increase investments in this specialty, both financially and educationally. In doing so, healthcare costs will be lowered, patient satisfaction will increase, and care will be better coordinated.
BACKGROUND: This study aimed to explore the perceptions, understanding, and utilization of PC before compared to during the COVID-19 pandemic among health system leadership.
METHODS: Semi-structured, in-depth interviews were conducted with leaders in a large healthcare system based in Massachusetts, United States.
RESULTS: A total of 22 in-depth interviews were completed at four facilities. Emerging themes included the role of PC before compared to during the COVID-19 pandemic, facilitators and barriers to PC delivery, and recommendations for future practice. Participants reported that the COVID-19 pandemic increased PC utilization, reinforced positive perceptions of the specialty, and emphasized its role in maximizing healthcare efficiency. Many participants found PC financing to be a barrier to delivery; some had an inaccurate understanding of how PC is reimbursed. When asked about their recommendations for improving future practice, participants noted improvements in coordination within the healthcare system and education of healthcare providers and future physicians in primary PC skills.
CONCLUSIONS: Our findings suggest that healthcare leadership increasingly understands the value of PC and its critical role within the health system and during future public health emergencies; this was further reinforced during the COVID-19 pandemic. Healthcare leadership recognizes and highlights the need to increase investments in this specialty, both financially and educationally. In doing so, healthcare costs will be lowered, patient satisfaction will increase, and care will be better coordinated.
摘要：
背景：姑息治疗在COVID-19大流行中起主导作用。然而,人们对卫生系统领导的看法知之甚少。
背景：这项研究旨在探索人们的看法，理解,与COVID-19大流行期间相比，卫生系统领导层对姑息治疗的利用情况。
方法：半结构化，与马萨诸塞州大型医疗保健系统的领导者进行了深入访谈，美国。
结果：在四个机构完成了22次深度访谈。新出现的主题包括姑息治疗之前与COVID-19大流行期间相比的作用，姑息治疗提供的促进者和障碍，并对今后的实践提出建议。参与者报告说，COVID-19大流行增加了姑息治疗的利用率，加强了对专业的积极看法，并强调其在最大限度地提高医疗保健效率方面的作用。许多参与者发现姑息治疗融资是交付的障碍；有些人对姑息治疗的报销方式有不准确的理解。当被问及他们对改进未来实践的建议时，参与者注意到医疗保健系统内的协调以及医疗保健提供者和未来医生在初级姑息治疗技能方面的教育有所改善.
结论：我们的研究结果表明，卫生领导越来越了解姑息治疗的价值及其在卫生系统和未来突发公共卫生事件中的关键作用；在COVID-19大流行期间，这一点得到了进一步加强。医疗保健领导层认识到并强调需要增加对这一专业的投资，财政和教育。在这样做的时候，医疗费用将会降低，患者满意度会提高，和护理将得到更好的协调。
背景：这项研究旨在探索人们的看法，理解,与COVID-19大流行期间相比，卫生系统领导层对姑息治疗的利用情况。
方法：半结构化，与马萨诸塞州大型医疗保健系统的领导者进行了深入访谈，美国。
结果：在四个机构完成了22次深度访谈。新出现的主题包括姑息治疗之前与COVID-19大流行期间相比的作用，姑息治疗提供的促进者和障碍，并对今后的实践提出建议。参与者报告说，COVID-19大流行增加了姑息治疗的利用率，加强了对专业的积极看法，并强调其在最大限度地提高医疗保健效率方面的作用。许多参与者发现姑息治疗融资是交付的障碍；有些人对姑息治疗的报销方式有不准确的理解。当被问及他们对改进未来实践的建议时，参与者注意到医疗保健系统内的协调以及医疗保健提供者和未来医生在初级姑息治疗技能方面的教育有所改善.
结论：我们的研究结果表明，卫生领导越来越了解姑息治疗的价值及其在卫生系统和未来突发公共卫生事件中的关键作用；在COVID-19大流行期间，这一点得到了进一步加强。医疗保健领导层认识到并强调需要增加对这一专业的投资，财政和教育。在这样做的时候，医疗费用将会降低，患者满意度会提高，和护理将得到更好的协调。
