Consensus Building on Health Indicators to Assess PC Global Development With an International Group of Experts

Arias-Casais, Natalia; Garralda, Eduardo; López–Fidalgo, Jesús; Rhee, John Y.; Pons, Juan José; Lima, Liliana De; Centeno, Carlos

doi:10.1016/j.jpainsymman.2019.04.024

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…We fully acknowledge that rigorously tested indicators of palliative care access and development do not yet exist, that collaborative efforts to develop such reliable indicators and reach consensus upon them should continue, 28 and that the project we report here remains (as we have stated previously) a work in progress and one which we seek continually to improve.…”

Section: Limitationsmentioning

confidence: 81%

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Clark

Clelland

Garralda

et al. 2020

Journal of Pain and Symptom Management

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Context. Palliative care is gaining ground globally and is endorsed in high-level policy commitments, but service provision, supporting policies, education, and funding are incommensurate with rapidly growing needs. Objectives. The objective of this study was to describe current levels of global palliative care development and report on changes since 2006. Methods. An online survey of experts in 198 countries generated 2017 data on 10 indicators of palliative care provision, fitted to six categories of development. Factor analysis and discriminant analysis showed the validity of the categorization. Spearman correlation analyses assessed the relationship with World Bank Income Level (WBIL), Human Development Index (HDI), and Universal Health Coverage (UHC). Results. Numbers (percentages) of countries in each development category were as follows: 1) no known palliative care activity, 47 (24%); 2) capacity-building, 13 (7%); 3a) isolated provision, 65 (33%); 3b) generalized provision, 22 (11%); 4a) preliminary integration into mainstream provision, 21 (11%); 4b) advanced integration, 30 (15%). Development levels were significantly associated with WBIL (r S ¼ 0.4785), UHC (r S ¼ 0.5558), and HDI (r S ¼ 0.5426) with P < 0.001. Net improvement between 2006 and 2017 saw 32 fewer countries in Categories 1/2, 16 more countries in 3a/3b, and 17 more countries in 4a/4b. Conclusion. Palliative care at the highest level of provision is available for only 14% of the global population and is concentrated in European countries. An 87% global increase in serious health-related suffering amenable to palliative care interventions is predicted by 2060. With an increasing need, palliative care is not reaching the levels required by at least half of the global population.

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Section: Limitationsmentioning

confidence: 81%

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Clark

Clelland

Garralda

et al. 2020

Journal of Pain and Symptom Management

Self Cite

217

164

View full text Add to dashboard Cite

show abstract

“…Conceptual work is continuing to refine the detailed dimensions that can make up an indicator of palliative care policy. A Brief Manual on Health Indicators Monitoring Global Palliative Care Development , 21 published after the present study was designed, and supported by a systematic review, 9 contains eight subindicators within the policy domain, each with a clear definition. These would merit a separate research study at the global level.…”

Section: Discussionmentioning

confidence: 99%

Palliative Care in Public Policy: Results from a Global Survey

Clelland

Steijn

Whitelaw

et al. 2020

Palliative Medicine Reports

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Background: Public policy has been a foundational component of the World Health Organization public health model for palliative care development since 1990. There is, however, limited evidence on the existence and character of palliative care policy at the country level. Objective: To identify, report on, and map the presence of national palliative care strategies, plans, legislation, and dedicated government resources in 198 countries. Design: An online survey generated 2017 data on indicators of national policy for palliative care. Subjects: In-country experts on palliative care. Measurements: The survey included specific questions on the existence and status of national strategies or plans, recognition of palliative care in national law, and dedicated government support. Results: Fifty-five countries have a national strategy or plan for palliative care of some sort, though levels of implementation vary. Forty-seven countries have some reference to palliative care in national law, and 24 have some form of stand-alone national law on palliative care provision or recognize it as a right in the constitution. Sixty-six countries have a dedicated section within government with responsibility for palliative care. Conclusions: There is a long way to go before palliative care around the world is universally supported by public policy intentions that will support its required development.

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“…These domains have been reported to correspond to the specialized development of PC [ 3 ]. However, recent discussions [ 2 , 4 ] indicate that specialized development of PC may reflect a small part of the greater PC need, and comprehensive access to PC and its coverage may be more accurately measured by determining the level of integration of PC into national health systems.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

et al. 2021

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Background Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.

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Consensus Building on Health Indicators to Assess PC Global Development With an International Group of Experts

Cited by 13 publications

References 11 publications

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Mapping Levels of Palliative Care Development in 198 Countries: The Situation in 2017

Palliative Care in Public Policy: Results from a Global Survey

Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development

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