Population’s Potential Accessibility to Specialized Palliative Care Services: A Comparative Study in Three European Countries

Background: Palliative care is a priority for health systems worldwide, yet equity in access remains unknown. To shed light on this issue, this study compares populations’ driving time to specialized palliative care services in three countries: Ireland, Spain, and Switzerland. Methods: Network analysis of the population’s driving time to services according to geolocated palliative care services using Geographical Information System (GIS). Percentage of the population living within a 30-min driving time, between 30 and 60 minutes, and over 60 min were calculated. Results: The percentage of the population living less than thirty minutes away from the nearest palliative care provider varies among Ireland (84%), Spain (79%), and Switzerland (95%). Percentages of the population over an hour away from services were 1.87% in Spain, 0.58% in Ireland, and 0.51% in Switzerland. Conclusion: Inequities in access to specialized palliative care are noticeable amongst countries, with implications also at the sub-national level.

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Use and timing of referral to specialized palliative care services for people with cancer: A mortality follow-back study among treating physicians in Belgium

PLoS ONE ◽

10.1371/journal.pone.0210056 ◽

2019 ◽

Vol 14 (1) ◽

pp. e0210056 ◽

Cited By ~ 3

Author(s):

Gaëlle Vanbutsele ◽

Luc Deliens ◽

Veronique Cocquyt ◽

Joachim Cohen ◽

Koen Pardon ◽

...

Keyword(s):

Palliative Care ◽

Care Services ◽

Palliative Care Services ◽

Specialized Palliative Care

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The Israel Cancer Association's role as a volunteer organization in forecasting, establishing, implementing and upgrading palliative care services in Israel

Palliative & Supportive Care ◽

10.1017/s1478951512000272 ◽

2012 ◽

Vol 11 (5) ◽

pp. 367-371 ◽

Cited By ~ 1

Author(s):

Livia Kislev ◽

Aliza Yaffe ◽

Miri Ziv ◽

Alexander Waller

Keyword(s):

Palliative Care ◽

Care Network ◽

Volunteer Organization ◽

Care Services ◽

Organizational Perspective ◽

Palliative Care Services ◽

Shed Light

AbstractThe Israel Cancer Association has contributed, as a key player, to the establishment and upgrade of palliative care in Israel. The aim of this article is to describe the involvement and contribution of the ICA, as a volunteer organization, from a clinical, educational, legal, and organizational perspective. Another main goal of this survey is to shed light on the palliative care network in Israel, in each one of these infrastructures.

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Refractory suffering at the end of life and the assisted dying debate: An interview study with palliative care nurses and doctors

Clinical Ethics ◽

10.1177/1477750920946613 ◽

2020 ◽

pp. 147775092094661

Author(s):

Kristine Espegren Gustad ◽

Åsta Askjer ◽

Per Nortvedt ◽

Olav Magnus S Fredheim ◽

Morten Magelssen

Keyword(s):

Palliative Care ◽

End Of Life ◽

Symptom Control ◽

Prima Facie ◽

Assisted Dying ◽

Analysis Framework ◽

Structured Interviews ◽

Care Services ◽

Palliative Care Services ◽

Shed Light

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved.

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Counting the use of specialized palliative care services

Palliative Care Research ◽

10.2512/jspm.7.374 ◽

2012 ◽

Vol 7 (2) ◽

pp. 374-381

Author(s):

Tatsuya Morita ◽

Nobuya Akizuki ◽

Satoshi Suzuki ◽

Hiroya Kinoshita ◽

Yutaka Shirahige ◽

...

Keyword(s):

Palliative Care ◽

Care Services ◽

Palliative Care Services ◽

Specialized Palliative Care

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Systematic Quality Monitoring For Specialized Palliative Care Services: Development of a Minimal Set of Quality Indicators for Palliative Care Study (QPAC)

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909116642174 ◽

2016 ◽

Vol 34 (6) ◽

pp. 532-546 ◽

Cited By ~ 12

Author(s):

Kathleen Leemans ◽

L. Deliens ◽

L. Van den Block ◽

R. Vander Stichele ◽

A. L. Francke ◽

...

Keyword(s):

Palliative Care ◽

Los Angeles ◽

Minimal Set ◽

Efficient Manner ◽

Care Services ◽

Feasibility Evaluation ◽

Patient Representatives ◽

Palliative Care Services ◽

Specialized Palliative Care

Background: A feasibility evaluation of a comprehensive quality indicator set for palliative care identified the need for a minimal selection of these indicators to monitor quality of palliative care services with short questionnaires for the patients, caregivers, and family carers. Objectives: To develop a minimal indicator set for efficient quality assessment in palliative care. Design: A 2 round modified Research ANd Development corporation in collaboration with the University of California at Los Angeles (RAND/UCLA) expert consultation. Setting/Patients: Thirteen experts in palliative care (professionals and patient representatives). Measurements: In a home assignment, experts were asked to score 80 developed indicators for “priority” to be included in the minimal set on a scale from 0 (lowest priority) to 9 (highest priority). The second round consisted of a plenary meeting in which the minimal set was finalized. Results: Thirty-nine of the 80 indicators were discarded, while 19 were definitely selected after the home assignment, and 22 were proposed for discussion during the meeting; 12 of these survived the selection round. The final minimal indicator set for palliative care consists of 5 indicators about the physical aspects of care; 6 about the psychosocial aspects of care; 13 about information, communication, and care planning; 5 about type of care; and 2 about continuity of care. Conclusion: A minimal set of 31 indicators reflecting all the important issues in palliative care was created for palliative care services to assess the quality of their care in a quick and efficient manner. Additional topic-specific optional modules are available for more thorough assessment of specific aspects of care.

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