Articles: palliative-care.
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The past 25 years have proved that palliative care is effective in improving care of seriously ill patients. Research attention must pivot to focus on policy changes and systems and models of care that ensure easy access to quality palliative care to all patients who need it. ⋯ The question of whether incentives should be used has arisen. Should we design treatment algorithms, such as for cardiopulmonary resuscitation, where palliative care is part of standard care and requires an "opt out"? Should payers pay more to health care organizations who demonstrate they provide universal access to palliative care and how can we control for unintended consequences? Should provision of specialist palliative care be required for a health care organization to be accredited? How can we advance the state of the science and best support the workforce?
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The lancet oncology · Jul 2022
Serious health-related suffering in Latin America: a secondary analysis.
Evidence from needs analysis can support health systems and improve morbidity and mortality rates related to life-limiting and life-threatening conditions, and is essential for the development of health care and educational plans to respond adequately to the disease burden of the population. The aim of this study was to establish the number of people with serious health-related suffering, defined as a negative impact on the functioning (eg, physical, social, or emotional) of a patient with a serious illness that cannot be mitigated without medical intervention, in 19 Spanish-speaking and Portuguese-speaking Latin American countries in 1990, 2000, 2010, and 2019. ⋯ None.
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The lancet oncology · Jul 2022
Current public perception of, and barriers to, palliative care in China: a mixed-methods study.
Cancer is a major cause of death in China, accounting for 2·56 million deaths in the country in 2018 alone. Yet, on that year, only 28 600 patients (1·1%) at the end of life received palliative care. Existing studies in palliative care have mainly been done in medical environments. The aim of this study was to focus instead on the general public and to identify the public's perceptions of, and demand for, various palliative care services, as well as barriers to palliative care in China. ⋯ Ministry of Education of China, Youth Project of Humanities and Social Sciences (project number 20XJC840001); China Postdoctoral Science Foundation (project number 2021M691521); and 2020 Young Teacher Development Project of the Chinese Universities Scientific Fund (project number 230600001002020030).
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J Pain Symptom Manage · Jul 2022
ReviewA Decade of Studying Drivers of Disparities in End-of-Life care for Black Americans: Using the NIMHD Framework for Health Disparities Research to Map the Path Ahead.
The purpose of this paper is to provide a review of the existing literature on racial disparities in quality of palliative and end-of-life care and to demonstrate gaps in the exploration of underlying mechanisms that produce these disparities. ⋯ The sociocultural environment, physical/built environment, behavioral and biological domains remain understudied areas of potential causal mechanisms for racial disparities in end-of-life care. In the Healthcare System domain, social influences including healthcare policy and law are understudied. In the sociocultural domain, the majority of the studies still focused on the individual level of influence, missing key areas of research in interpersonal discrimination and local and societal structural discrimination. Studies that focus on individual factors should be better screened to ensure that they are of high quality and avoid stigmatizing Black communities.
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Background: Public and private hospitals treat different patient populations, which may impact resources to deliver palliative care (PC). Objectives: Compare public and private hospital PC service structures, processes, and treatment outcomes. Design: Retrospective data analysis of the Palliative Care Quality Network between 2018 and 2019. ⋯ Conclusions: Public hospital PC teams treat a more diverse symptomatic population. Yet, they achieved comparable outcomes with similar staffing to private hospitals. These findings have important ramifications for policy makers and public institution leaders.