How many people need palliative care for cancer and non-cancer diseases in a middle-income country? Analysis of mortality data
Abstract
Introduction: Ageing of the population and the accompanying increase in prevalence of chronic illnesses mean that more people will need palliative care. This need has not been extensively quantied in middle-income countries to policy planning and expanding health-care.
Objective: Provide an estimate of the need of palliative care services in Colombia and compare these needs with the current available offer.
Methods: Cross-sectional study based on mortality statistics for Colombia for the period 2012–2016. We calculated age- and sex-specic numbers of deaths and mortality rates from death certicates for dened chronic illnesses to estimate the prevalence of palliative care need in Colombia, and contrasted this information with the current offer according to the Colombian Observatory of Palliative Care.
Results: The numbers of deaths requiring palliative care increased from 107,065 in 2012 to 128,670 in 2016 (61.2% of total deaths). The causes of these deaths vary by age group, with a clearly more important proportion of heart and cerebrovascular diseases and dementia in advances ages, and HIV/AIDS in young ages. In all age groups, malignant neoplasms are an important part of the causes of deaths of those requiring palliative care (31.3% of all deaths in 2016). Contrasting this needs, in most areas there is no or very limited offer of palliative care services.
Conclusions: A real palliative care policy, including a vast increase in training opportunities in the eld and regulation allowing a wide range of health practitioners to be involved in palliative care, is necessary in Colombia to improve the palliative care offer.
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