Organizing palliative care for rural populations: a systematic review of the evidence

Evans, R. W.; Stone, Debbie; Elwyn, Glyn

doi:10.1093/fampra/cmg312

Cited by 98 publications

(69 citation statements)

References 25 publications

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“…Common difficulties experienced by general practioners (GPs) in providing palliative care include pain and symptom control, emotional distress of the family and patient, and dealing with their own emotional reactions. 2 Studies in the United Kingdom showed similar results, along with a strong desire among GPs for 24-hour access to a specialist palliative care team. 3 Difficulties involved in providing community-based palliative care include knowing when to refer to a palliative care team 4 , accessing specialists out of hours 5 , knowledge of resources and services available, 5 care for those with noncancer diagnoses, 6 and management of complex symptoms.…”

Section: Introductionmentioning

confidence: 78%

Palliative Care Telephone Consultation: Who Calls and What do they Need to Know?

Ridley¹,

Gallagher

2008

Journal of Palliative Medicine

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British Columbia's Palliative Care Hotline provides a valuable service that has been utilized province-wide with increasing frequency over the 6 years it has been in operation. It serves a variety of professionals and significant number of patients. Rural communities utilize the service with the most frequency, indicating the support needed in these communities. Similar services should be considered in other jurisdictions.

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Section: Introductionmentioning

confidence: 78%

Palliative Care Telephone Consultation: Who Calls and What do they Need to Know?

Ridley¹,

Gallagher

2008

Journal of Palliative Medicine

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“…These authors identified 26 studies suitable for inclusion in the review, but the diversity and lack of research methods in the reports made it difficult to analyse the models. 34 The majority of service delivery models in Australia are specialist services delivering palliative care to a small subset of the population. 32 Given that not all people living with a lifelimiting illness need, or desire, the same level and access to specialist palliative care services, access to these scarce specialist services should be based on the level of need.…”

Section: Health Care Organisationmentioning

confidence: 99%

“…1,2,5 Although various modes of service delivery have been identified 13,18,29,32 there is limited literature about the process of planning, implementing and evaluating palliative care service delivery, particularly in rural Australia. 29,34 Several studies have endeavoured to define a service delivery model for rural palliative care but encountered difficulties. The evidence suggests that a population-based 1 Specialist palliative care service delivery based on a population-based approach with four delineated levels of care…”

Section: Patient and Familymentioning

confidence: 99%

Enhancing palliative care delivery in a regional community in Australia

Phillips¹,

Davidson²,

Jackson³

et al. 2006

Aust. Health Review

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Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales.Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalised integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this ACCESS TO PALLIATIVE CARE is a fundamental right for people in Australia and is endorsed by government policy. 1,2 Access, a key component of all palliative care service delivery models, implies fairness not determined by geographical location. [1][2][3][4][5] Despite this ideal, the increasing demand for palliative care in regional, rural and remote areas, combined with the limited number of palliative care specialists, presents considerable challenges for health service planners. 6,7 This discussion document reviews the evidence pertaining to model-of-care development, the policy environment and existing rural palliative care models in operation in rural Australia. This review was conducted to inform the development What is known about the topic? The provision of palliative care in rural and remote areas presents significant service delivery challenges, but it is not known how best to address these challenges. What does this paper add? This paper explores issues related to palliative care service delivery in a rapidly expanding regional coastal community. The paper outlines a populationbased planning strategy to enhance capacity. What are the implications for practitioners?The authors propose the development of a palliative care service that builds upon the existing specialist service with greater involvement of generalist providers and ensures service development and delivery is explicitly linked to consumer needs. Mid-north coast New South WalesThe mid-north coast consists of the Coffs Harbour, Bellingen and Nambucca local government areas (LGA) which now reside within the central network of the recently created North Coast Area Health Service. Although the reorganisation of the area health service boundaries in NSW occurred subsequent to the completion of this need assessment, this does not alter the significance of these findings. 8 This area has a population of 97 774 people, with the largest concentrated population residing in the Coffs Harbour LGA and the remaining population in smaller coastal townships, which are popular holiday des...

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“…Compared to urban dwellers, persons in rural communities' exhibit poorer health status and greater need for health care yet are less likely to receive HPC (Evans, Stone, & Elywn, 2003;Romanow, 2002). HPC in rural areas is usually delivered by general physicians; whereas in urban areas, the population density allows for HPC specialists to work alongside nursing and medical personnel providing skills, advice, and continuing education (Evans et al, 2003). Rural communities are challenged to recruit and retain HPC specialists.…”

mentioning

confidence: 99%

Breaking Down Barriers: Hospice Palliative Care as a Human Right in Canada

Freeman

Heckman

Naus

et al. 2013

Educational Gerontology

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Organizing palliative care for rural populations: a systematic review of the evidence

Abstract: There is little published work on this topic. Most of the work identifies problems in the delivery of palliative care in rural areas. Whilst primary care professionals are seen as having a key role, there is a need to discover both their views and their needs in this field.

Cited by 98 publications

References 25 publications

Palliative Care Telephone Consultation: Who Calls and What do they Need to Know?

Palliative Care Telephone Consultation: Who Calls and What do they Need to Know?

Enhancing palliative care delivery in a regional community in Australia

Breaking Down Barriers: Hospice Palliative Care as a Human Right in Canada

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