The early identification of palliative care patients: preliminary processes and estimates from urban, family medicine practices.

Primary care providers are positioned to identify patients, well in advance of their deaths, who could benefit from palliative care services, but little is known about how to correctly identify these upstream palliative care patients. This article reports on efforts to devise a methodology for identifying such patients and to offer preliminary estimates of their prevalence in urban, primary care practices. The data presented here suggest 2 conclusions: (1) that electronic databases may be used to create a preliminary screen to assist clinicians in the early identification of patients in need of palliative care, and (2) that 1% to 3% of patients in primary care practices may benefit from palliative care services. Currently, there are no standards regarding the role of primary care providers in end-of-life care and it is hoped that this article will contribute to developing such standards.