Palliative Care Service Use in Four European Countries: A Cross-National Retrospective Study via Representative Networks of General PractitionersReport as inadecuate




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Background

Due to a rising number of deaths from cancer and other chronic diseases a growing number of people experience complex symptoms and require palliative care towards the end of life. However, population-based data on the number of people receiving palliative care in Europe are scarce. The objective of this study is to examine, in four European countries, the number of people receiving palliative care in the last three months of life and the factors associated with receiving palliative care.

Methods

Cross-national retrospective study. Over two years 2009–2010, GPs belonging to representative epidemiological surveillance networks in Belgium, the Netherlands, Italy, and Spain registered weekly all deaths of patients ≥18 years in their practices and the care they received in the last three months of life using a standardized form. Sudden deaths were excluded.

Results

We studied 4,466 deaths. GPs perceived to have delivered palliative care to 50% of patients in Belgium, 55% in Italy, 62% in the Netherlands, and 65% in Spain p<.001. Palliative care specialists attended to 29% of patients in the Netherlands, 39% in Italy, 45% in Spain, and 47% in Belgium p<.001. Specialist palliative care lasted a median inter-quartile range of 15 23 days in Belgium to 30 70 days in Italy p<.001. Cancer patients were more likely than non-cancer patients to receive palliative care in all countries as were younger patients in Italy and Spain with regard to specialist palliative care.

Conclusions

Although palliative care is established in the countries studied, there are considerable differences in its provision. Two potentially underserved groups emerge non-cancer patients in all countries and older people in Italy and Spain. Future research should examine how differences in palliative care use relate to both patient characteristics and existing national health care policies.



Author: Lara Pivodic , Koen Pardon, Lieve Van den Block, Viviane Van Casteren, Guido Miccinesi, Gé A. Donker, Tomás Vega Alonso, José

Source: http://plos.srce.hr/



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