How many people need palliative care? A study developing and comparing methods for population-based estimates
| Autor: | Yvonne E. Kaloki, E. Iris Groeneveld, Fliss E M Murtagh, Irene J Higginson, Julia Verne, Claudia Bausewein |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Palliative care Adolescent Population Population based Young Adult Nursing International Classification of Diseases Cause of Death medicine Terminal care Health Status Indicators Humans Hospital Mortality Registries Child education Aged Health Services Needs and Demand Terminal Care education.field_of_study business.industry Public health Palliative Care Infant Newborn Infant General Medicine Middle Aged Anesthesiology and Pain Medicine England Child Preschool Population Surveillance Family medicine Chronic Disease Needs assessment Female business End-of-life care Needs Assessment |
| Zdroj: | Palliative Medicine. 28:49-58 |
| ISSN: | 1477-030X 0269-2163 |
| DOI: | 10.1177/0269216313489367 |
| Popis: | Background: Understanding the need for palliative care is essential in planning services. Aim: To refine existing methods of estimating population-based need for palliative care and to compare these methods to better inform their use. Design: (1) Refinement of existing population-based methods, based on the views of an expert panel, and (2) application/comparison of existing and refined approaches in an example dataset. Existing methods vary in approach and in data sources. (a) Higginson used cause of death/symptom prevalence, and using pain prevalence, estimates that 60.28% (95% confidence interval = 60.20%–60.36%) of all deaths need palliative care, (b) Rosenwax used the International Statistical Classification of Diseases and Related Health Problems–10th Revision ( ICD-10) causes of death/hospital-use data, and estimates that 37.01% (95% confidence interval = 36.94%–37.07%) to 96.61% (95% confidence interval = 96.58%–96.64%) of deaths need palliative care, and (c) Gómez-Batiste used percentage of deaths plus chronic disease data, and estimates that 75% of deaths need palliative care. Setting/participants: All deaths in England, January 2006–December 2008, using linked mortality and hospital episode data. Results: Expert panel review identified changing practice (e.g. extension of palliative care to more non-cancer conditions), changing patterns of hospital/home care and multiple, rather than single, causes of death as important. We therefore refined methods (using updated ICD-10 causes of death, underlying/contributory causes, and hospital use) to estimate a minimum of 63.03% (95% confidence interval = 62.95%–63.11%) of all deaths needing palliative care, with lower and upper mid-range estimates between 69.10% (95% confidence interval = 69.02%–69.17%) and 81.87% (95% confidence interval = 81.81%–81.93%). Conclusions: 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. |
| Databáze: | OpenAIRE |
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