Woitha Kathrin, Garralda Eduardo, Martin-Moreno Jose María, Clark David, Centeno Carlos
Institute for Culture and Society, University of Navarra, Pamplona, Spain; Institute for Health Research of Navarra, Pamplona, Spain.
Institute for Culture and Society, University of Navarra, Pamplona, Spain; Institute for Health Research of Navarra, Pamplona, Spain.
J Pain Symptom Manage. 2016 Sep;52(3):370-7. doi: 10.1016/j.jpainsymman.2016.03.008. Epub 2016 Jun 7.
There is growing interest in monitoring palliative care (PC) development internationally. One aspect of this is the ranking of such development for comparative purposes.
To generate a ranking classification and to compare scores for PC development in the countries of the European Union, 2007 and 2013. PC "development" in this study is understood as a combination of the existence of relevant services in a country ("resources") plus the capacity to develop further resources in the future ("vitality").
"Resources" comprise indicators of three types of PC services per population (inpatient palliative care units and inpatient hospices, hospital support teams, and home care teams). "Vitality" of PC is estimated by numerical scores for the existence of a national association, a directory of services, physician accreditation, attendances at a key European conference and volume of publications on PC development. The leading country (by raw score) is then considered as the reference point against which all other countries are measured. Different weightings are applied to resources (75%) and vitality (25%). From this, an overall ranking is constructed.
The U.K. achieved the highest level of development (86% of the maximum possible score), followed by Belgium and overall The Netherlands (81%), and Sweden (80%). In the resources domain, Luxembourg, the U.K., and Belgium were leading. The top countries in vitality were Germany and the U.K. In comparison to 2007, The Netherlands, Malta, and Portugal showed the biggest improvements, whereas the positions of Spain, France, and Greece deteriorated.
The ranking method permitted a comparison of palliative care development between countries and shows changes over time. Recommendations for improving the ranking include improvements to the methodology and greater explanation of the levels and changes it reveals.
国际上对监测姑息治疗（PC）发展的兴趣日益浓厚。其中一个方面是为了进行比较而对这种发展进行排名。
生成一个排名分类，并比较2007年和2013年欧盟国家PC发展的得分。本研究中的PC“发展”被理解为一个国家相关服务的存在（“资源”）加上未来进一步发展资源的能力（“活力”）的结合。
“资源”包括每人口三种类型PC服务的指标（住院姑息治疗单位和住院临终关怀机构、医院支持团队以及家庭护理团队）。PC的“活力”通过国家协会的存在、服务目录、医生认证、参加关键欧洲会议的情况以及关于PC发展的出版物数量的数值得分来估计。然后将得分最高的国家（按原始分数）作为与所有其他国家进行比较的参考点。对资源（75%）和活力（25%）应用不同的权重。据此构建总体排名。
英国实现了最高的发展水平（达到最高分的86%），其次是比利时和总体排名的荷兰（81%）以及瑞典（80%）。在资源领域，卢森堡、英国和比利时领先。活力方面排名靠前的国家是德国和英国。与2007年相比，荷兰、马耳他和葡萄牙进步最大，而西班牙、法国和希腊的排名下降。
该排名方法允许对各国之间的姑息治疗发展进行比较，并显示出随时间的变化。改进排名的建议包括改进方法以及对其揭示的水平和变化进行更详细的解释。
