<P> In the UK in 2005 there were just under 1,700 hospice services consisting of 220 inpatient units for adults with 3,156 beds, 33 inpatient units for children with 255 beds, 358 home care services, 104 hospice at home services, 263 day care services and 293 hospital teams . These services together helped over 250,000 people in 2003 and 2004 . </P> <P> Hospice in the United States has grown from a volunteer - led movement to a significant part of the health care system . In 2005 around 1.2 million persons and their families received hospice care . Hospice is the only Medicare benefit that includes pharmaceuticals, medical equipment, twenty - four - hour / seven - day - a-week access to care and support for loved ones following a death . Most hospice care is delivered at home . Hospice care is also available to people in home - like hospice residences, nursing homes, assisted living facilities, veterans' facilities, hospitals, and prisons . </P> <P> The first United States hospital - based palliative care consult service was developed by the Wayne State University School of Medicine in 1985 at Detroit Receiving Hospital . The first palliative medicine program in the United States was started in 1987 by Declan Walsh, MD at the Cleveland Clinic Cancer Center in Cleveland, Ohio . This is a comprehensive integrated program, responsible for several notable innovations in US palliative medicine; the first clinical and research fellowship (1991), acute care palliative medicine inpatient unit (1994), and Chair in Palliative Medicine (1994). The program evolved into The Harry R. Horvitz Center for Palliative Medicine which was designated as a World Health Organization international demonstration project and accredited by the European Society for Medical Oncology as an Integrated Center of Oncology and Palliative Care . Other programs followed: most notable the Palliative Care Program at the Medical College of Wisconsin (1993); Pain and Palliative Care Service, Memorial Sloan - Kettering Cancer Center (1996); and The Lilian and Benjamin Hertzberg Palliative Care Institute, Mount Sinai School of Medicine (1997). Since then there has been a dramatic increase in hospital - based palliative care programs, now numbering more than 1,400 . Eighty percent of US hospitals with more than 300 beds have a program . </P> <P> A widely cited report in 2007 of a randomized controlled trial with 298 patients found that palliative care delivered to patients and their caregivers at home improved satisfaction with care while decreasing medical service use and the cost of care . </P>

When was palliative care medicine first established as an international medical subspecialty
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