BMJ 2002;324:1291-1292 ( 1 June )

Editorials

Quality care at the end of life

Should be recognised as a global problem for public health and health systems

The first 150 words of the full text of this article appear below.

Worldwide, 56 million people die each year, 85% of these in developing countries. 1 2 Yet little is known about the quality of care they receive at the end of their lives. The movement for improving the quality of care at the end of life is primarily focused on industrialised countries. Until it is seen as a global problem for public health and health systems, efforts to improve it will not make much impact in the world.

Public health
Quality of care at the end of life is a global public health problem because of the large number of people involved. If each death affects five other people in terms of giving informal care and grieving relatives and friends, the total number of people affected each year by end of life care is about 300 million, or 5% of the world's population.

Some of the interventions that could be used to improve care are . . . [Full text of this article]
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  • Finlay, E., Shreve, S., Casarett, D. (2008). Nationwide Veterans Affairs Quality Measure for Cancer: The Family Assessment of Treatment at End of Life. JCO 26: 3838-3844 [Abstract] [Full text]  
  • Brandt, H. E, Deliens, L., Steen, J. T v. d., Ooms, M. E, Ribbe, M. W, Wal, G. v. (2005). The last days of life of nursing home patients with and without dementia assessed with the Palliative care Outcome Scale. Palliat Med 19: 334-342 [Abstract]  
  • Teno, J. M., Clarridge, B. R., Casey, V., Welch, L. C., Wetle, T., Shield, R., Mor, V. (2004). Family Perspectives on End-of-Life Care at the Last Place of Care. JAMA 291: 88-93 [Abstract] [Full text]  
  • Singer, P. A, Wolfson, M. (2003). "The best places to die". BMJ 327: 173-174 [Full text]  
  • Sepulveda, C., Habiyambere, V., Amandua, J., Borok, M., Kikule, E., Mudanga, B., Ngoma, T., Solomon, B. (2003). Quality care at the end of life in Africa. BMJ 327: 209-213 [Full text]  
  • Murray, S. A, Grant, E., Grant, A., Kendall, M. (2003). Dying from cancer in developed and developing countries: lessons from two qualitative interview studies of patients and their carers. BMJ 326: 368-368 [Abstract] [Full text]  
  • Kite, S (2002). Upstream from death. JRSM 95: 529-530 [Full text]  

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