[:en]Does quality of palliative care improve in Europe?[:ro]S-a îmbunătățit calitatea îngrijirilor paliative în Europa?[:]

[:en]Wim J.A. van den Heuvel, PhD, Honorary Professor, University of Groningen, the Netherlands.

Address for correspondence: heuvelwim@hotmail.com

Abstract

Objective:
This paper analyses which countries in Europe did increase or decrease their end-of-life care efforts in the last five years. It describes the overall ranking of 27 European countries on the 2015 Quality of Death Index and it compares the changes in ranking on the Quality of Death Index of 22 European countries between 2010 and 2015.

Method:
To assess changes in quality of palliative care the scores and ranking of the Quality of Death Index of 2010 and 2015 were compared. The comparison was made on the Quality of Death Index as well as on two of its domains: affordability of palliative care and quality of care.

Results:
The countries ranking highest on the Quality of Death Index are situated in West-North Europe, the lowest ranking ones in East-South Europe. There is a wide gap between countries ranking high and low. Efforts to improve palliative care vary over time within countries. In Austria and Hungary the ranking on the quality of death index decreased, but in Finland and Portugal the index increased significantly. Overall, the comparison of ranking shows that ´negative´ changes in ranking between 2010 and 2015 seem more frequently in Central/-Eastern European countries as compared to Scandinavian and Southern-West European countries.

Conclusion:
The comparison of ‘quality of death’ between 22 European countries indicates that palliative care lacks to be an integral part of health care. This applies especially to Central-Eastern European countries. In half of the participating European countries the quality of death did not improve over the last five years. Almost half of the European countries provide insufficient palliative care services for their suffering citizens.

Key words: palliative care, end-of-life care, quality of death, international comparison

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