The Qualy Observatory, WHO Collaborating Centre for Palliative Care Public Health Programs, Catalan Institute of Oncology, Barcelona, Spain.
Curr Opin Support Palliat Care. 2012 Sep;6(3):371-8. doi: 10.1097/SPC.0b013e328356aaed.
We describe conceptual innovations in palliative care epidemiology and the methods to identify patients in need of palliative care, in all settings.In middle-high-income countries, more than 75% of the population will die from chronic progressive diseases. Around 1.2-1.4% of such populations suffer from chronic advanced conditions, with limited life expectancy. Clinical status deteriorates progressively with frequent crises of needs, high social impact, and high use of costly healthcare resources.
The innovative concept of patients with advanced chronic diseases and limited life prognosis has been addressed recently, and several methods to identify them have been developed.
The challenges are to promote early and shared interventions, extended to all patients in need, in all settings of the social care and healthcare systems; to design and develop Palliative Care Programmes with a Public Health perspective. The first action is to identify, using the appropriate tools early in the clinical evolution of the disease, all patients in need of palliative care in all settings of care, especially in primary care services, nursing homes, and healthcare services responsible for care provision for these patients; to promote appropriate care in patients with advanced diseases with prognosis of poor survival.
我们描述了姑息治疗流行病学的概念创新，以及在所有环境中识别需要姑息治疗的患者的方法。在中高收入国家，超过 75%的人口将死于慢性进行性疾病。大约有 1.2-1.4%的此类人群患有慢性晚期疾病，预期寿命有限。临床状况随着需求的频繁危机、高社会影响和高成本医疗资源的使用而逐渐恶化。
最近提出了患有晚期慢性疾病和有限预期寿命的患者的创新概念，并开发了几种识别他们的方法。
挑战在于在社会关怀和医疗保健系统的所有环境中，促进早期和共同的干预措施，扩展到所有有需要的患者；从公共卫生角度设计和制定姑息治疗方案。首要行动是使用适当的工具，在疾病的临床演变早期识别所有有姑息治疗需求的患者，尤其是在初级保健服务、养老院和负责为这些患者提供护理的医疗保健服务中；在生存预后较差的晚期疾病患者中推广适当的护理。
