How many people need palliative care? A study developing and comparing methods for population-based estimates

Abstract

Death registration data using both underlying and contributory causes can give reliable estimates of the population-based need for palliative care, without needing symptom or hospital activity data. In high-income countries, 69%-82% of those who die need palliative care.

Palliative Care in Brazil: With a View to Future Needs?

“…By relating the updated estimate of Maciel and Bertega [36] to the simulations of the methods of MacNamara et al [32], Rosenwax et al [34], Murtagh et al [33], Kerr et al [35] and the Brazilian Ministry of Health [27], we verified that the need for palliative care is closer to the Murtagh's method.…”

“…Simulations of settings were used to adapt and match the Brazilian mortality data with MacNamara & Rosenwax and Murtagh methods, searching to identify the proportion of individuals that could benefit from palliative care in the last year of life. A maximal estimate defined by MacNamara et al [43] and Murtagh et al [33] included all deaths, except external causes and maternal, neonatal or perinatal deaths. A total of 1,045,726, accounting for 85.2% of all deaths, could be potential palliative care patients (maximal estimate).…”

“…[31] In Brazil, we also cannot match the general mortality statistics with data from hospital admission. [32,[33][34][35][36] Based on the study of Scholten et al [31], "The size of the population potentially in need of palliative care in Germany -an estimation based on death registration data", we adapted the Brazilian mortality data registered in 2014 to the MacNamara & Rosenwax and Murtagh methods.…”

Providing end-of-life care in general practice: findings of a national GP questionnaire survey

“…1,2 In the UK, more people are living longer with multiple long-term conditions and cancer such that illness trajectories are changing. [3][4][5] A proactive approach to care, with early identification of palliative care needs and care planning, has long been advocated, 4,5 and remains at the centre of national strategies in the UK. [6][7][8][9] GPs, along with the wider palliative care and community nursing teams, provide most of the medical care for patients who die in the community at end of life.…”

Los Cuidados Paliativos. Un nuevo reto para la Medicina Interna

“…Al contrario de lo que puede parecer, la atención a la cronicidad avanzada y la enfermedad terminal sigue siendo un reto del Sistema Nacional de Salud, cuyo objetivo debe ser simplificar los métodos de identificación del paciente crónico con edad avanzada y las necesidades de cuidados paliativos. En este sentido, los distintos estudios de prevalencia de que disponemos hablan de que hasta el 1,4-26% de los pacientes que están en domicilio podrían beneficiarse de cuidados paliativos, y este porcentaje se eleva al 66-70% cuando tenemos en cuenta las instituciones sociosanitarias 3,4 . Así, tanto en el ámbito de la Atención Primaria como en el medio hospitalario, pocos son los pacientes (se estima que en torno a un 15-20%, según las series) que entran en programas de cuidados paliativos 5 , casi siempre en unidades específicas y enfermos en su mayoría con patología oncoló-gica.…”