Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2013 Dec 30;8(12):e84440.
doi: 10.1371/journal.pone.0084440. eCollection 2013.

Palliative care service use in four European countries: a cross-national retrospective study via representative networks of general practitioners

Lara Pivodic  1 , Koen Pardon  1 , Lieve Van den Block  1 , Viviane Van Casteren  2 , Guido Miccinesi  3 , Gé A Donker  4 , Tomás Vega Alonso  5 , José Lozano Alonso  5 , Pierangelo Lora Aprile  6 , Bregje D Onwuteaka-Philipsen  7 , Luc Deliens  8 ; EURO IMPACT
Collaborators, Affiliations
Clinical Trial

Palliative care service use in four European countries: a cross-national retrospective study via representative networks of general practitioners

Lara Pivodic et al. PLoS One. .

Abstract

Background: Due to a rising number of deaths from cancer and other chronic diseases a growing number of people experience complex symptoms and require palliative care towards the end of life. However, population-based data on the number of people receiving palliative care in Europe are scarce. The objective of this study is to examine, in four European countries, the number of people receiving palliative care in the last three months of life and the factors associated with receiving palliative care.

Methods: Cross-national retrospective study. Over two years (2009-2010), GPs belonging to representative epidemiological surveillance networks in Belgium, the Netherlands, Italy, and Spain registered weekly all deaths of patients (≥ 18 years) in their practices and the care they received in the last three months of life using a standardized form. Sudden deaths were excluded.

Results: We studied 4,466 deaths. GPs perceived to have delivered palliative care to 50% of patients in Belgium, 55% in Italy, 62% in the Netherlands, and 65% in Spain (p<.001). Palliative care specialists attended to 29% of patients in the Netherlands, 39% in Italy, 45% in Spain, and 47% in Belgium (p<.001). Specialist palliative care lasted a median (inter-quartile range) of 15 (23) days in Belgium to 30 (70) days in Italy (p<.001). Cancer patients were more likely than non-cancer patients to receive palliative care in all countries as were younger patients in Italy and Spain with regard to specialist palliative care.

Conclusions: Although palliative care is established in the countries studied, there are considerable differences in its provision. Two potentially underserved groups emerge non-cancer patients in all countries and older people in Italy and Spain. Future research should examine how differences in palliative care use relate to both patient characteristics and existing national health care policies.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Hasselaar J, Engels Y, Menten J, Jaspers B, Vissers K (2012) The burden of non-acute dying on society: dying of cancer and chronic disease in the European Union. BMJ Support Palliat Care. doi:10.1136/bmjspcare-2011-000162 - DOI - PubMed
    1. Hall S, Petkova H, Tsouros AD, Costantini M, Higginson IJ (2011) Palliative care for older people: better practices. Copenhagen: World Health Organization, Regional Office for Europe.
    1. Davies E, Higginson IJ (2004) Palliative care: the solid facts. Copenhagen: World Health Organization, Regional Office for Europe.
    1. World Health Organisation (2010) WHO Definition of Palliative Care. Available: http://www.who.int/cancer/palliative/definition/en/. Accessed 2012 Nov 14.
    1. Recommendation Rec (2003) 24 of the Committee of Ministers to member states on the organisations of palliative care (2003). Strasbourg: Council of Europe.

Publication types