Facts and indicators on palliative care development in 52 countries of the WHO European region: results of an EAPC task force

Abstract

The European Association for Palliative Care Task (EAPC) Force on the Development of Palliative Care in Europe was created in 2003 and the results of its work are now being reported in full, both here and in several other publications. The objective of the Task Force is to assess the degree of palliative care development in the European Region as defined by the World Health Organization (WHO). The Task Force is a collaboration between EAPC, the International Observatory on End of Life Care, Help the Hospices and the International Association for Hospice and Palliative Care. The University of Navarra have collaborated in the dissemination of results and is involved in further developments of this group. Four studies, each with different working methods, made up the study protocol: a literature review, a review of all the existing palliative care directories in Europe, a qualitative ;Eurobarometer' survey and a quantitative ;Facts Questionnaire' survey. The work of the Task Force covers the entire WHO European Region of 52 countries. In this article we present a comparative study on the development of palliative care in Europe, drawing on all four elements of the study. Different models of service delivery have been developed and implemented throughout the countries of Europe. For example, in addition to the UK, the countries of Germany, Austria, Poland and Italy have a well-developed and extensive network of hospices. The model for mobile teams or hospital support teams has been adopted in a number of countries, most notably in France. Day Centres are a development that is characteristic of the UK with hundreds of these services currently in operation. The number of beds per million inhabitants ranges between 45-75 beds in the most advanced European countries, to only a few beds in others. Estimates on the number of physicians working full time in palliative care are shown. The countries with the highest development of palliative care in their respective subregions as measured in terms of ratio of services per one million inhabitants are: Western Europe - UK (15); Central and Eastern Europe - Poland (9); Commonwealth of Independent States - Armenia (8). This paper also presents indicators on the development of palliative care based on the bibliometric analysis of scientific journals and on the vitality of the palliative care movement in each country.

Opportunities for Palliative Care in Public Health

“…Several PC organizations have published reports on the status of national, regional, and global PC development (14,45,53); however, these reports have had limited impact on the monitoring of PC by member states. A systematic review of PC indicators developed by several organizations and PC groups also demonstrated that the vast majority of indicators are focused on the quality of care provisions and patient outcomes (65).…”

MASCC/ESMO/EAPC survey of palliative programs

“…The number of palliative care specialists range from 1 per 100,000 to 1 per 1.6 million population [11]. Challenges to palliative care structures and service are prioritization based on both the oncologist and patient perspective.…”

Comparative Analysis of Specialization in Palliative Medicine Processes Within the World Health Organization European Region

“…14 The status of PM and its development are poorly documented in the published literature. The first mapping of PM in Europe was performed and reported in a European Association for Palliative Care (EAPC) survey 15 that mentions seven of the 53 countries that have PM as a specialty or subspecialty and another 10 countries where the development of PM is in progress. The recent EAPC Atlas of Palliative Care in Europe 2013 16 shows 15 countries that offer official PM certification programs: Czech Republic, Finland, France, Georgia, Germany, Ireland, Israel, Italy, Latvia, Malta, Norway, Poland, Romania, Slovakia, and the U.K.…”