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

Abstract

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.

Geographic Information Systems Utilization in Pediatric End-of-Life Research: A Scoping Review

“…A majority of the articles (88.2%) were published in the past 10 years. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] Ten articles focused on hospice care, [21][22][23][24][25][26][28][29][30][31] 4 on palliative care, 18,20,32,33, and 3 on end-of-life care broadly. 19,34,35 Care for young children (0-12 years) was the most common age group specified in the literature.…”

“…19,34,35 Care for young children (0-12 years) was the most common age group specified in the literature. 18-32,35, The next most common age group was adolescents between 13 to 20 years, [18][19][20][21][22][23][24][25]27,[29][30][31][32]35 and lastly young adults over the age of 21. 19,35 A majority of studies (76.5%) examined the U.S. geographic region, 19,[21][22][23][24][25][26][27][28][29][30][31]35 while 2 studies were set in Europe 18,32 and 1 in Canada.…”

“…20 The unit of analysis varied from geographic regions 18,20,21,30,33 to persons, 19,[22][23][24][25][26][27][28][29]31,35 to organizations. 32 Types of spatial data included facility location data: hospitals, homes, and hospices. 18,21,[28][29][30]32,33 Census block data regarding patient location at time of death was utilized in 2 studies.…”

“…32 Types of spatial data included facility location data: hospitals, homes, and hospices. 18,21,[28][29][30]32,33 Census block data regarding patient location at time of death was utilized in 2 studies. 19,35 A single study focused on the comparison of rural/urban geographic distribution of mortality by race utilizing data from the Tennessee Cancer Registry.…”

“…31 ArcGIS was the most common GIS software (70.6%) used in the articles. 20,[22][23][24][25][26][27][28][29]32,33 Other software used in spatial studies included Microsoft Excel 21,31 (17.6%) 1 and AT-LANTES/SPSS 18,19 (11.8%). Eleven studies used multiple years of data in their GIS analysis.…”