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英国医学公报文章:在新冠疫情期间英国的姑息治疗和临终关怀资源配置。

British medical bulletin article: resourcing of palliative and end of life care in the UK during the Covid-19 pandemic.

机构信息

Policy & Public Affairs Manager for England, Marie Curie, England.

出版信息

Br Med Bull. 2022 Jul 9;142(1):44-51. doi: 10.1093/bmb/ldac013.

Abstract

INTRODUCTION

Covid-19 led to a sustained increase in deaths in all four United Kingdom nations, placing strain on the UK's palliative and end-of-life care sector and raising concerns about the long-term sustainability of the sector's funding and resourcing model in the face of rising demand for these services in the coming decades.

SOURCES OF DATA

Published research, Marie Curie, King's College London Cicely Saunders Institute, Hull York Medical School, University of Hull, University of Cambridge, National Statistics, PubMed, DOI.

AREAS OF AGREEMENT

Care for people at the end of their lives is a core part of the UK's health and care system with demand set to increase significantly as the UK's population ages.

AREAS OF CONTROVERSY

The UK's funding model for palliative and end-of-life care, with most care delivered by charitable sector providers and reliant on charitable donations, may be unsustainable in the face of increasing demand.

GROWING POINTS

The Covid-19 pandemic led to rapid service innovation in palliative and end-of-life care, and providers should assess which of and how these innovations can be retained after the pandemic.

AREAS TIMELY FOR DEVELOPING RESEARCH

Although there has been a rapid growth in knowledge during Covid-19, gaps still remain including: the reasons underlying shifts to deaths at home and the implications for family carers; the education needs of the wider healthcare workforce in palliative care; the impact of specialist palliative care services on the wider health system, including hospital admissions and place of death; and inequalities in the experiences of dying, death and bereavement during Covid-19 among groups such as those from lower socioeconomic groups and BAME communities.

摘要

引言

新冠疫情导致英国四个国家的死亡人数持续增加,给英国的姑息治疗和临终关怀部门带来了压力,并引发了人们对该部门在未来几十年面临这些服务需求上升时,其资金和资源模式长期可持续性的担忧。

数据来源

已发表的研究、玛莉·居里、伦敦国王学院西塞莉·桑德斯研究所、赫尔约克医学院、赫尔大学、剑桥大学、国家统计局、PubMed、DOI。

共识领域

临终关怀是英国卫生和保健系统的核心部分,随着英国人口老龄化,对临终关怀的需求将大幅增加。

争议领域

英国姑息治疗和临终关怀的资金模式,大多数护理由慈善部门提供者提供,并依赖慈善捐款,面对不断增长的需求,可能是不可持续的。

新的增长点

新冠疫情导致姑息治疗和临终关怀服务的快速创新,提供者应评估在疫情结束后,这些创新中有哪些可以保留,以及如何保留。

值得研究的领域

尽管在新冠疫情期间知识迅速增长,但仍存在差距,包括:导致死亡在家中转移的原因及其对家庭照顾者的影响;更广泛的医疗保健人员在姑息治疗方面的教育需求;专科姑息治疗服务对更广泛的卫生系统的影响,包括住院和死亡地点;以及在新冠疫情期间,来自社会经济地位较低的群体和 BAME 社区等群体在临终、死亡和丧亲方面的经历存在不平等现象。

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