Statewide and Regional Variation in Hospice and Palliative Care Protocols in Emergency Medical Services in the United States

Across the U.S., HPC protocols remain inconsistently integrated into EMS systems. Fewer than one in four reviewed protocols included any HPC-specific guidance, and most lacked comprehensive components recommended by national guidelines. Broader adoption of HPC protocols and alignment with expert recommendations may improve the delivery of compassionate, goal-concordant care to a growing population of seriously ill patients in the out-of-hospital setting.