Research funding for palliative medicine

Background: Medical care for seriously ill patients has been acknowledged to be inadequate and multiple reports have called for increased investment in palliative medicine research. Objective: To identify funding sources of palliative medicine research published form 2003-2005 and to examine National Institutes of Health (NIH) funding of palliative medicine research from 2001-2005. Methods: We sought to identify United States publications related to adult palliative medicine research from 2003-2005 and their funding sources. We reviewed all articles published in the major palliative medicine journals and additionally, we reviewed all articles published in major medicine journals and relevant sub-specialty journals which were identified in Pub-Med using the key words "palliative care," "end-of-life care," "hospice" and "end-of-life." From all identified articles, we abstracted all sources of funding detailed. We then compiled a list of U.S. palliative medicine researchers from 2001-2005 using the published first and last authors in the above article review, the editorial boards of palliative medicine journals, and other organizations. To examine NIH funding, we cross-matched this list of researchers against all NIH grants funded from 2001-2005. Results: We identified 388 palliative medicine research articles and 2,197 investigators. Seventy-two percent of papers identified received extramural funding: 31% from the NIH, 51% from foundations, and 16% from other sources. Only 109 investigators received NIH funding and the National Cancer Institute (NCI), National Institute of Nursing Research (NINR), and National Institute on Aging (NIA) funded 85% of all NIH awards. Conclusions: Research funding, particularly federal funding, for palliative medicine research is inadequate to support improvements in care for the most seriously ill patients and their families.