Lucas Morin1,2, Régis Aubry2, Luisa Frova3, Roderick MacLeod4, Donna M Wilson5, Martin Loucka6, Agnes Csikos7, Miguel Ruiz-Ramos8, Marylou Cardenas-Turanzas9, YongJoo Rhee10, Joan Teno11, Joakim Öhlén12,13, Luc Deliens14,15, Dirk Houttekier15, Joachim Cohen15. 1. 1 Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden. 2. 2 French National Observatory on End-of-Life Care, Paris, France. 3. 3 Italian National Insitute of Statistics, Rome, Italy. 4. 4 HammondCare and University of Sydney, Greenwich, NSW, Australia. 5. 5 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada. 6. 6 Center for Palliative Care, Prague, Czech Republic. 7. 7 University of Pécs Medical School, Pécs, Hungary. 8. 8 Regional Ministry of Equality, Health and Social Policies in Andalusia, Seville, Spain. 9. 9 McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA. 10. 10 Dongduk Women's University, Seoul, Korea. 11. 11 Gerontology and Geriatrics, Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA, USA. 12. 12 Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden. 13. 13 Institute of Health and Care Sciences and University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden. 14. 14 Department of Medical Oncology, University Hospital Ghent, Ghent, Belgium. 15. 15 End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.
Abstract
BACKGROUND: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed. AIM: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries. DESIGN: This is a cross-sectional study using death certificate data. SETTING/PARTICIPANTS: All adults (⩾18 years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand ( N = 4,908,114). Underlying causes of death were used to apply three estimation methods developed by Rosenwax et al., the French National Observatory on End-of-Life Care, and Murtagh et al., respectively. RESULTS: The proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 38% to 74%. We found important cross-country variation: the population potentially in need of palliative care was lower in Mexico (24%-58%) than in the United States (41%-76%) and varied from 31%-83% in Hungary to 42%-79% in Spain. Irrespective of the estimation methods, female sex and higher age were independently associated with the likelihood of being in need of palliative care near the end of life. Home and nursing home were the two places of deaths with the highest prevalence of palliative care needs. CONCLUSION: These estimations of the size of the population potentially in need of palliative care provide robust indications of the challenge countries are facing if they want to seriously address palliative care needs at the population level.
BACKGROUND: To implement the appropriate services and develop adequate interventions, detailed estimates of the needs for palliative care in the population are needed. AIM: To estimate the proportion of decedents potentially in need of palliative care across 12 European and non-European countries. DESIGN: This is a cross-sectional study using death certificate data. SETTING/PARTICIPANTS: All adults (⩾18 years) who died in 2008 in Belgium, Czech Republic, France, Hungary, Italy, Spain (Andalusia, 2010), Sweden, Canada, the United States (2007), Korea, Mexico, and New Zealand ( N = 4,908,114). Underlying causes of death were used to apply three estimation methods developed by Rosenwax et al., the French National Observatory on End-of-Life Care, and Murtagh et al., respectively. RESULTS: The proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 38% to 74%. We found important cross-country variation: the population potentially in need of palliative care was lower in Mexico (24%-58%) than in the United States (41%-76%) and varied from 31%-83% in Hungary to 42%-79% in Spain. Irrespective of the estimation methods, female sex and higher age were independently associated with the likelihood of being in need of palliative care near the end of life. Home and nursing home were the two places of deaths with the highest prevalence of palliative care needs. CONCLUSION: These estimations of the size of the population potentially in need of palliative care provide robust indications of the challenge countries are facing if they want to seriously address palliative care needs at the population level.
Entities:
Keywords:
Palliative care; cause of death; end-of-life care; needs assessment
Authors: Manon S Boddaert; Chantal Pereira; Jeroen Adema; Kris C P Vissers; Yvette M van der Linden; Natasja J H Raijmakers; Heidi P Fransen Journal: BMJ Support Palliat Care Date: 2020-12-22 Impact factor: 4.633