Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide

Lara Pivodic; Tinne Smets; Merryn Gott; Katherine E. Sleeman; Borja Arrue; Marylou Cardenas Turanzas; Karolina Pechova; Hana Kodba Čeh; Tong Jen Lo; Miharu Nakanishi; Yong Joo Rhee; Maud ten Koppel; Donna M. Wilson; Lieve Van den Block

doi:10.1177/0269216320972036

Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide

Lara Pivodic^*, Tinne Smets, Merryn Gott, Katherine E. Sleeman, Borja Arrue, Marylou Cardenas Turanzas, Karolina Pechova, Hana Kodba Čeh, Tong Jen Lo, Miharu Nakanishi, Yong Joo Rhee, Maud ten Koppel, Donna M. Wilson, Lieve Van den Block

^*Corresponding author for this work

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

17 Citations (Scopus)

Abstract

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.

Original language	English
Journal	Palliative medicine
DOIs	https://doi.org/10.1177/0269216320972036
Publication status	Accepted/In press - 2020

Keywords

documentary analysis (not a MeSH heading; research design used)
health policy
older people (not a MeSH heading but important identifier of population)
palliative care

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10.1177/0269216320972036

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Pivodic, L., Smets, T., Gott, M., Sleeman, K. E., Arrue, B., Cardenas Turanzas, M., Pechova, K., Kodba Čeh, H., Lo, T. J., Nakanishi, M., Rhee, Y. J., ten Koppel, M., Wilson, D. M., & Van den Block, L. (Accepted/In press). Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide. Palliative medicine. https://doi.org/10.1177/0269216320972036

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title = "Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide",

abstract = "Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.",

keywords = "documentary analysis (not a MeSH heading; research design used), health policy, older people (not a MeSH heading but important identifier of population), palliative care",

author = "Lara Pivodic and Tinne Smets and Merryn Gott and Sleeman, {Katherine E.} and Borja Arrue and {Cardenas Turanzas}, Marylou and Karolina Pechova and {Kodba {\v C}eh}, Hana and Lo, {Tong Jen} and Miharu Nakanishi and Rhee, {Yong Joo} and {ten Koppel}, Maud and Wilson, {Donna M.} and {Van den Block}, Lieve",

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doi = "10.1177/0269216320972036",

language = "English",

journal = "Palliative medicine",

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Pivodic, L, Smets, T, Gott, M, Sleeman, KE, Arrue, B, Cardenas Turanzas, M, Pechova, K, Kodba Čeh, H, Lo, TJ, Nakanishi, M, Rhee, YJ, ten Koppel, M, Wilson, DM & Van den Block, L 2020, 'Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide', Palliative medicine. https://doi.org/10.1177/0269216320972036

TY - JOUR

T1 - Inclusion of palliative care in health care policy for older people

T2 - A directed documentary analysis in 13 of the most rapidly ageing countries worldwide

AU - Pivodic, Lara

AU - Smets, Tinne

AU - Gott, Merryn

AU - Sleeman, Katherine E.

AU - Arrue, Borja

AU - Cardenas Turanzas, Marylou

AU - Pechova, Karolina

AU - Kodba Čeh, Hana

AU - Lo, Tong Jen

AU - Nakanishi, Miharu

AU - Rhee, Yong Joo

AU - ten Koppel, Maud

AU - Wilson, Donna M.

AU - Van den Block, Lieve

PY - 2020

Y1 - 2020

N2 - Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.

AB - Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.

KW - documentary analysis (not a MeSH heading; research design used)

KW - health policy

KW - older people (not a MeSH heading but important identifier of population)

KW - palliative care

UR - http://www.scopus.com/inward/record.url?scp=85097497149&partnerID=8YFLogxK

U2 - 10.1177/0269216320972036

DO - 10.1177/0269216320972036

M3 - Article

AN - SCOPUS:85097497149

SN - 0269-2163

JO - Palliative medicine

JF - Palliative medicine

ER -

Inclusion of palliative care in health care policy for older people: A directed documentary analysis in 13 of the most rapidly ageing countries worldwide

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