title: Australian health policy and end of life care for people with chronic disease: an analysis.
abstract: End of life care for people with advanced chronic disease is a growing international imperative, with the majority of deaths in the world now related to chronic disease. The provision of care that meets the needs of people with advanced chronic disease must be guided by appropriate policy. The key policy areas impacting directly on end of life care are related to chronic disease, palliative care and, increasingly, aged care. This paper describes the outcomes of an audit of Australian chronic disease and end of life/palliative care policies. We identified that chronic disease health policies/strategies demonstrate a focus on prevention, early intervention and management, with scant recognition of end of life care needs. The majority assume that a referral to palliative care will address end of life care needs for people with chronic disease. By contrast, palliative care policies recognise the need for the incorporation of a palliative approach into advanced chronic disease care, but there are few connections between these two policy areas. Whilst palliative care policies intersect with carer and advance care planning policies, chronic disease policy does not. Key concerns requiring consideration when developing policy in this area are discussed and possible policy options identified.
authors.affiliation: University of Adelaide, North Terrace, Adelaide 5005, Australia. Electronic address: teresa.burgess@adelaide.edu.au.
authors.forename: Teresa
authors.initials: T
authors.lastname: Burgess
authors.affiliation: University of Adelaide, North Terrace, Adelaide 5005, Australia. Electronic address: annette.braunackmayer@adelaide.edu.au.
authors.forename: Annette
authors.initials: A
authors.lastname: Braunack-Mayer
authors.affiliation: University of Adelaide, North Terrace, Adelaide 5005, Australia; Mary Potter Hospice, Calvary North Adelaide Hospital, 89 Strangways Terrace, North Adelaide, SA 5006, Australia; Central Adelaide Palliative Care Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia. Electronic address: gregory.crawford@adelaide.edu.au.
authors.forename: Gregory B
authors.initials: GB
authors.lastname: Crawford
authors.affiliation: University of Adelaide, North Terrace, Adelaide 5005, Australia. Electronic address: justin.beilby@adelaide.edu.au.
authors.forename: Justin
authors.initials: J
authors.lastname: Beilby
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D006291:Health Policy; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D010166:Palliative Care / Q000458:organization & administration / Q000706:statistics & numerical data; D013219:State Government; D013727:Terminal Care / Q000458:organization & administration / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Australia; Chronic disease; End of life care; Health policy