title: Coverage and development of specialist palliative care services across the World Health Organization European Region (2005-2012): Results from a European Association for Palliative Care Task Force survey of 53 Countries.
abstract: BACKGROUND
  The evolution of the provision of palliative care specialised services is important for planning and evaluation.
  
  
  OBJECTIVE
  To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region - home care teams, hospital support teams and inpatient palliative care services.
  
  
  METHODS
  Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Palliative Care in Europe. Significant development of each type of services was demonstrated by adjusted residual analysis, ratio of services per population and 2012 coverage (relationship between provision of available services and demand services estimated to meet the palliative care needs of a population). For the measurement of palliative care coverage, we used European Association for Palliative Care White Paper recommendations: one home care team per 100,000 inhabitants, one hospital support team per 200,000 inhabitants and one inpatient palliative care service per 200,000 inhabitants. To estimate evolution at the supranational level, mean comparison between years and European sub-regions is presented.
  
  
  RESULTS
  Of 53 countries, 46 (87%) provided data. Europe has developed significant home care team, inpatient palliative care service and hospital support team in 2005-2012. The improvement was statistically significant for Western European countries, but not for Central and Eastern countries. Significant development in at least a type of services was in 21 of 46 (46%) countries. The estimations of 2012 coverage for inpatient palliative care service, home care team and hospital support team are 62%, 52% and 31% for Western European and 20%, 14% and 3% for Central and Eastern, respectively.
  
  
  CONCLUSIONS
  Although there has been a positive development in overall palliative care coverage in Europe between 2005 and 2012, the services available in most countries are still insufficient to meet the palliative care needs of the population.
authors.affiliation: ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain Palliative Medicine Group, Area of Oncology and Haematology, Navarra's Health Research Institute (IDISNA), Pamplona, Spain European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy ccenteno@unav.es.
authors.forename: Carlos
authors.initials: C
authors.lastname: Centeno
authors.affiliation: European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy Department of Anesthesiology and Critical Care Medicine and Palliative Care Program, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lynch
authors.affiliation: ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain Palliative Medicine Group, Area of Oncology and Haematology, Navarra's Health Research Institute (IDISNA), Pamplona, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Garralda
authors.affiliation: ATLANTES Research Program, Institute for Culture and Society (ICS), University of Navarra, Pamplona, Spain Palliative Medicine Group, Area of Oncology and Haematology, Navarra's Health Research Institute (IDISNA), Pamplona, Spain.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Carrasco
authors.affiliation: Department of Health Sciences, Public University of Navarra, Pamplona, Spain Clinical Epidemiology Group, Epidemiology and Public Health Area, Navarra's Health Research Institute (IDISNA), Pamplona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Guillen-Grima
authors.affiliation: European Association for Palliative Care (EAPC) Task Force on the Development of Palliative Care in Europe, Milan, Italy School of Interdisciplinary Studies, University of Glasgow, Dumfries Campus, Dumfries, UK Wellcome Trust, London, UK University of Navarra, Pamplona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Clark
mesh_terms: D003431:Cross-Cultural Comparison; D005060:Europe; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006699:Home Care Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D010166:Palliative Care / Q000379:methods / Q000458:organization & administration* / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D014944:World Health Organization
keywords: Europe; Palliative care; coverage; development