Hawai'i is average when it comes to providing palliative care in hospitals, according to a new report from a group that advocates increasing the amount of palliative care available in the U.S.

The report from the Center to Advance Palliative Care gave Hawai'i a "C" grade for access to the care, the same grade it gave to the nation as a whole. Overall, half of states got an A or B grade, with about 40 percent receiving a C.

Palliative programs have grown as medical providers pay more attention to the care given people with serious, chronic and terminal illnesses. Palliative care is focused on the relief of pain, symptoms and stress of the illness and aims to improve quality of life for these patients.

"A lot of people think palliative care is about death and dying, but it's about living," said Dr. Diane Faran of the University of Hawai'i John A. Burns School of Medicine, and medical director of Hospice Hawai'i.

The Center to Advance Palliative Care said about 90 million Americans live with serious and life-threatening illnesses, but that most people experience inadequately treated symptoms, fragmented care, poor communication with doctors and enormous strains on their family caregivers.

The report was of interest at UH's medical school, which requires students to receive instruction in palliative care. It issued a statement saying while Hawai'i has more board-certified palliative care physicians per capita than other states, there is still insufficient access to the care.

The report said no palliative care programs exist at hospitals on Kaua'i or in Maui County.