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Need for palliative care outstrips services says Economist Quality of Death Index

06 October 2015

The Quality of Death Index, commissioned by the Lien Foundation, a Singaporean philanthropic organisation, is based on extensive research and interviews with over 120 palliative care experts from across the world.

It shows that in general, income levels are a strong indicator of the availability and quality of palliative care, with wealthy countries clustered at the top. The UK is top of the list, as it was in the previous index released in 2010. Australia and New Zealand take second and third place, as they did in 2010, while rich European and Asian countries dominate the top 20, along with the US in ninth place and Canada in 11th.

As expected, many developing countries are still unable to provide basic pain management due to limitations in staff and basic infrastructure. Yet some countries with lower income levels demonstrate the power of innovation and individual initiative.

For example, Panama (31st) is building palliative care into its primary care services, Mongolia (28th) has seen rapid growth in hospice facilities and teaching programmes, and Uganda (35th) has made huge advances in the availability of opioid painkillers.

For the first time The EIU has also compared the supply of palliative care – as revealed in the Index – with the demand for such care.

The demand analysis, based on countries’ demographic profiles and the burden of diseases for which palliative care is necessary, shows China to be among the most vulnerable from population ageing and the rising incidence of conditions such as cardiovascular disease, which accounted for one-third of all deaths in the country in 2012.

Many other developing countries will also need to work hard to meet rising future need as the incidence of non-communicable disease increases and their populations grow older.

David Line, the editor of the report, said: “Since the first Quality of Death Index was published this issue has certainly risen up the global agenda, as shown by the World Health Assembly resolution last year calling for improved standards of palliative care across the world.

“But much more can be done, even in countries that rank highly in the Index. It is an issue that will affect us all – a good quality of death should be regarded as a human right.”

The release of the report coincides with World Hospice and Palliative Care Day, a unified day of action organised by the Worldwide Hospice Palliative Care Alliance (WHPCA) and the International Children’s Palliative Care Network (ICPCN) to raise awareness of the need for hospice and palliative care worldwide.

Dr Stephen R Connor, WHPCA Senior Fellow, said: “This new report, released ahead of World Hospice and Palliative Care Day, will help highlight the enormous work that still needs to be done to bring palliative care especially to low and middle income countries where lack of education on palliative care, lack of essential medicines, and lack of government support continue to lead to unnecessary suffering.”

The 2015 Quality of Death Index and supporting materials are available to download online.

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