Sánchez-Cárdenas Miguel Antonio, Garralda Eduardo, Arias-Casais Natalia Sofia, Benitez Sastoque Edgar Ricardo, Van Steijn Danny, Moine Sébastien, Murray Scott A, Centeno Carlos
ATLANTES Global Palliative Care Observatory, Institute for Culture and Society, University of Navarra, Pamplona, Spain
ATLANTES Global Palliative Care Observatory, Institute for Culture and Society, University of Navarra, Pamplona, Spain.
BMJ Support Palliat Care. 2021 Sep 13. doi: 10.1136/bmjspcare-2021-003181.
To estimate the capacity of European countries to integrate palliative care (PC) into their health systems through PC service provision for patients of all ages, with different care needs and diseases, in various settings and by a range of providers.
Secondary analysis of survey data from 51 countries with 22 indicators explored the integration of available PC resources for children, for patients of all ages, at the primary care level, for oncology and cardiac patients, and in long-term care facilities. We also measured volunteer participation. Results were quantified, converted into weighted subscores by area and combined into a single 'Integration Capacity Score (ICS)' for each country.
Thirty-eight countries reported 543 specialised paediatric PC services. One-third of all surveyed countries reported 20% or more of patients with PC needs at the primary care level. Twenty-four countries have a total of 155 designated centres that integrate oncology and PC. Eight countries were pioneering cardiology services that integrate PC. Eight reported a volunteer workforce of over 1000 and 12 had policies regulating PC provision and interventions in long-term care facilities. Across all indicators, 39 countries (76%) score from low to very low integration capacity, 8 (16%) score at an intermediate level, and 4 (8%; the Netherlands, UK, Germany and Switzerland) report a high-level integration of PC into their health systems.
Variable progress according to these indicators shows that most European countries are still in the process of integrating PC into their health systems.
评估欧洲国家通过为所有年龄段、有不同护理需求和疾病的患者，在各种环境中由一系列提供者提供姑息治疗（PC）服务，将姑息治疗纳入其卫生系统的能力。
对来自51个国家的调查数据进行二次分析，采用22项指标，探讨了儿童、所有年龄段患者、初级保健层面、肿瘤患者和心脏病患者以及长期护理机构中可用的PC资源整合情况。我们还衡量了志愿者的参与情况。结果进行了量化，按地区转换为加权子分数，并为每个国家合并成一个单一的“整合能力得分（ICS）”。
38个国家报告了543项专门的儿科PC服务。所有接受调查的国家中有三分之一报告称，初级保健层面有20%或更多有PC需求的患者。24个国家共有155个整合肿瘤学和PC的指定中心。8个国家率先开展了整合PC的心脏病学服务。8个国家报告志愿者人数超过1000人，12个国家制定了规范长期护理机构中PC服务提供和干预措施的政策。在所有指标中，39个国家（76%）的整合能力得分从低到极低；8个国家（16%）得分处于中等水平；4个国家（8%；荷兰、英国、德国和瑞士）报告PC已高度整合到其卫生系统中。
根据这些指标的不同进展表明，大多数欧洲国家仍在将PC纳入其卫生系统的进程中。
