Coverage and development of specialist palliative care services across the World Health Organization European Region (2005-2012): Results from a European Association for Palliative Care Task Force survey of 53 Countries

Carlos Centeno; Thomas Lynch; Eduardo Garralda; José Miguel Carrasco; Francisco Guillen-Grima; David Clark

doi:10.1177/0269216315598671

Coverage and development of specialist palliative care services across the World Health Organization European Region (2005-2012): Results from a European Association for Palliative Care Task Force survey of 53 Countries

Palliat Med. 2016 Apr;30(4):351-62. doi: 10.1177/0269216315598671. Epub 2015 Jul 31.

Authors

Carlos Centeno¹, Thomas Lynch², Eduardo Garralda³, José Miguel Carrasco³, Francisco Guillen-Grima⁴, David Clark⁵

Affiliations

¹ ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain Palliative Medicine Group, Area of Oncology and Haematology, Navarra's Health Research Institute (IDISNA), Pamplona, Spain European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy ccenteno@unav.es.
² European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy Department of Anesthesiology and Critical Care Medicine and Palliative Care Program, Johns Hopkins School of Medicine, Baltimore, MD, USA.
³ ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain Palliative Medicine Group, Area of Oncology and Haematology, Navarra's Health Research Institute (IDISNA), Pamplona, Spain.
⁴ Department of Health Sciences, Public University of Navarra, Pamplona, Spain Clinical Epidemiology Group, Epidemiology and Public Health Area, Navarra's Health Research Institute (IDISNA), Pamplona, Spain.
⁵ European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy School of Interdisciplinary Studies, University of Glasgow, Dumfries Campus, Dumfries, UK Wellcome Trust, London, UK University of Navarra, Pamplona, Spain.

Abstract

Background: The evolution of the provision of palliative care specialised services is important for planning and evaluation.

Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region - home care teams, hospital support teams and inpatient palliative care services.

Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented.

Results: Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005-2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively.

Conclusion: Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.

Keywords: Europe; Palliative care; coverage; development.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cross-Cultural Comparison
Europe
Health Care Surveys
Health Services Accessibility / statistics & numerical data*
Home Care Services / organization & administration*
Home Care Services / standards
Home Care Services / statistics & numerical data
Humans
Inpatients* / statistics & numerical data
Palliative Care / methods
Palliative Care / organization & administration*
Palliative Care / statistics & numerical data
Patient Care Team / organization & administration*
Patient Care Team / standards
World Health Organization