Arias-Casais, N. (Natalia)
- Publications
- item.page.relationships.isContributorAdvisorOfPublication
- item.page.relationships.isContributorOfPublication
12 results
Search Results
Now showing 1 - 10 of 12
- Additional indicators to assess palliative care development(2019-02-22) Pons-Izquierdo, J.J. (Juan José); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Lima, L. (Liliana) de; López-Fidalgo, J. (Jesús); Rhee, J.Y. (John Y.)This is a short compilation of Health Indicators Assessing the Level of Palliative Care Development at the International Level. These are additional indicators to another published book: Brief Manual on Health Indicators Monitoring Global Palliative Care Development (http://hdl.handle.net/10171/56523).
- EAPC Atlas of Palliative Care in Europe 2019(EAPC Press, 2019) Mosoiu, D. (Daniela); Pons-Izquierdo, J.J. (Juan José); Garralda, E. (Eduardo); Hasselaar, J. (Jeroen); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Lima, L. (Liliana) de; Clark, D. (David); Rhee, J.Y. (John Y.); Ling, J. (Julie)
- Palliative care coverage across European National Health Systems: proposal of a synthetic indicator(MDPI, 2021) Steijn, D. (Danny) van; Sánchez-Cárdenas, M. (Miguel); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Benítez-Sastoque, E.R. (Edgar Ricardo)Background: The coverage of palliative care (PC) may be understood as a country’s capacity to offer prevention and relief from serious health-related suffering in relation to an existing need. The aim of this study is to estimate European countries´ coverage capacities. Method: Secondary analysis of three indicators, including the number of specialized services (SSPC), integration capacity scores (ICS) and the PC needs. By means of a K-medians clustering supervised algorithm, three coverage profiles were obtained: (1) Advanced: countries with high ICS and SSPC, and low PC needs; (2) Limited: countries with low ICS and SSPC, and low PC needs; and (3) Low: countries with low ICS and SSPC and high PC needs. Results: On average, the ratio of specialized services per population was 0.79 per 100,000 inhabitants, the average ICS was 19.62 and the average number of deceased patients with SHS per 100,000 inhabitants was 5.69. Twenty countries (41%) reached an advanced coverage profile. Nine countries (18%) demonstrated a limited coverage profile; and 20 countries (41%) fell under a low-coverage capacity. Conclusion: The level of palliative care coverage across Europe shows that 59% of European countries have either limited or very low availability of PC resources as regards their palliative care needs.
- Palliative care integration indicators: an European regional analysis(BMJ, 2021) Steijn, D. (Danny) van; Hutter, S. (Sébastien); Sánchez-Cárdenas, M. (Miguel); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Benítez-Sastoque, E.R. (Edgar Ricardo); Murray, S. (Scott)Objective To estimate the capacity of European countries to integrate palliative care (PC) into their health systems through PC service provision for patients of all ages, with different care needs and diseases, in various settings and by a range of providers. Methods Secondary analysis of survey data from 51 countries with 22 indicators explored the integration of available PC resources for children, for patients of all ages, at the primary care level, for oncology and cardiac patients, and in long-term care facilities. We also measured volunteer participation. Results were quantified, converted into weighted subscores by area and combined into a single ‘Integration Capacity Score (ICS)’ for each country. Results Thirty-eight countries reported 543 specialised paediatric PC services. One-third of all surveyed countries reported 20% or more of patients with PC needs at the primary care level. Twenty-four countries have a total of 155 designated centres that integrate oncology and PC. Eight countries were pioneering cardiology services that integrate PC. Eight reported a volunteer workforce of over 1000 and 12 had policies regulating PC provision and interventions in long-term care facilities. Across all indicators, 39 countries (76%) score from low to very low integration capacity, 8 (16%) score at an intermediate level, and 4 (8%; the Netherlands, UK, Germany and Switzerland) report a high-level integration of PC into their health systems. Conclusion Variable progress according to these indicators shows that most European countries are still in the process of integrating PC into their health systems.
- Mapping pediatric palliative care development in the WHO-European Region: children living in low-middle income countries are less likely to access it(Elsevier, 2020) Pons-Izquierdo, J.J. (Juan José); Marston, J. (Joan); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Lima, L. (Liliana) de; Rhee, J.Y. (John Y.); Downing, J. (Julia); Ling, J. (Julie); Chambers, L. (Lizzie)Context: Approximately 170,000 children in need of palliative care die every year in Europe without access to it. This field remains an evolving specialty with unexplored development. Objectives: To conduct the first regional assessment of pediatric palliative care (PPC) development and provision using data from the European Association for Palliative Care atlas of palliative care 2019. Methods: Two surveys were conducted. The first one included a single question regarding PPC service provision and was addressed by European Association for Palliative Care atlas informants. The second one included 10 specific indicators derived from an open-ended interview and rating process; a specific network of informants was enabled and used as respondents. Data were analyzed and presented in the map of the figure. Results: Data on PPC service provision were gathered from 51 of 54 (94%) European countries. Additional data were collected in 34 of 54 (62%) countries. A total of 680 PPC services were identified including 133 hospices, 385 home care services, and 162 hospital services. Nineteen countries had specific standards and norms for the provision of PPC. Twenty-two countries had a national association, and 14 countries offered education for either pediatric doctors or nurses. In seven countries, specific neonatal palliative care referral services were identified. Conclusion: PPC provision is flourishing across the region; however, development is less accentuated in low-to-middle-income countries. Efforts need to be devoted to the conceptualization and definition of the models of care used to respond to the unmet need of PPC in Europe. The question whether specialized services are required or not should be further explored. Strategies to regulate and cover patients in need should be adapted to each national health system.
- Evaluating the integration of palliative care in national health systems: an indicator rating process with EAPC task force members to measure advanced palliative care development(BMC, 2021) Sánchez-Cárdenas, M. (Miguel); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Rhee, J.Y. (John Y.)Background: Palliative care (PC) development cannot only be assessed from a specialized provision perspective. Recently, PC integration into other health systems has been identified as a component of specialized development. Yet, there is a lack of indicators to assess PC integration for pediatrics, long-term care facilities, primary care, volunteering and cardiology. Aim: To identify and design indicators capable of exploring national-level integration of PC into the areas mentioned above. Methods: A process composed of a desk literature review, consultation and semi-structured interviews with EAPC task force members and a rating process was performed to create a list of indicators for the assessment of PC integration into pediatrics, long-term care facilities, primary care, cardiology, and volunteering. The new indicators were mapped onto the four domains of the WHO Public Health Strategy. Results: The literature review identified experts with whom 11 semi-structured interviews were conducted. A total of 34 new indicators were identified for national-level monitoring of palliative care integration. Ten were for pediatrics, five for primary care, six for long-term care facilities, seven for volunteering, and six for cardiology. All indicators mapped onto the WHO domains of policy and education while only pediatrics had an indicator that mapped onto the domain of services. No indicators mapped onto the domain of use of medicines. Conclusion: Meaningful contributions are being made in Europe towards the integration of PC into the explored fields. These efforts should be assessed in future regional mapping studies using indicators to deliver a more complete picture of PC development.
- Global palliative care: from need to action(Elsevier BV, 2019) Centeno, C. (Carlos); Arias-Casais, N. (Natalia)Katherine Sleeman and colleagues report the first worldwide projection of the future global burden of serious health-related suffering. The calculation followed the methods used by the Lancet Commission on Palliative Care and Pain Relief assessing global palliative care need. Combining these methods with WHO’s revised global and regional projections of mortality up to 2060,3 the authors estimate the global burden of serious health-related suffering requiring palliative care by world regions and age groups for 20 health conditions. The vision of the future delivered by this Article is alarming: “By 2060, an estimated 48 million people (47% of all deaths globally) will die each year with serious healthrelated suffering, and 83% of these deaths will occur in low-income and middle-income countries”.1 These numbers indicate that 130000 people worldwide will die every day with serious health-related suffering by 2060, the equivalent to twice the size of a Super Bowl stadium. The real burden of serious health-related suffering is even greater because the authors’ calculations are based on mortality data and do not include the burden of people living with serious health-related suffering who do not die in a given period.
- The importance of assessing the need for palliative care to avoid unnecessary suffering at life's end(Gobierno de Navarra, 2020) Centeno, C. (Carlos); Arias-Casais, N. (Natalia)El interesante estudio de Martínez Ríos y col1, sobre pacientes susceptibles de cuidados paliativos que fallecen en domicilio en Málaga, concluye que un tercio de ellos no se identificaron como pacientes paliativos en su historia clínica y, por tanto, no se incluyeron en el Proceso Asistencial Integrado de Cuidados Paliativos de la Junta de Andalucía. Se recoge en el mismo trabajo que la proporción de pacientes fallecidos en el domicilio en 2015, e identificados como susceptibles de cuidados paliativos, fue muy alta para pacientes con cáncer (87%) y muy baja para pacientes con EPOC (38%), insuficiencia cardíaca (23%) y demencias (20%).
- Trends analysis of specialized palliative care services in 51 countries of the WHO European region in the last 14 years(SAGE Publications, 2020) Pons-Izquierdo, J.J. (Juan José); Garralda, E. (Eduardo); Centeno, C. (Carlos); Arias-Casais, N. (Natalia); Lima, L. (Liliana) de; Radbruch, L. (Lukas); López-Fidalgo, J. (Jesús); Rhee, J.Y. (John Y.)Background: Service provision is a key domain to assess national-level palliative care development. Three editions of the European Association for Palliative Care (EAPC) Atlas of Palliative Care monitored the changes in service provision across Europe since 2005. Aim: To study European trends of specialized service provision at home care teams, hospital support teams, and inpatient palliative care services between 2005 and 2019. Design: Secondary analysis was conducted drawing from databases on the number of specialized services in 2005, 2012, and 2019. Ratios of services per 100,000 inhabitants and increase rates on number of services for three periods were calculated. Analysis of variance (ANOVA) analyses were conducted to determine significant changes and chi-square to identify countries accounting for the variance. Income-level and sub-regional ANOVA analysis were undertaken. Setting: 51 countries. Results: Forty-two countries (82%) increased the number of specialized services between 2005 and 2019 with changes for home care teams (104% increase-rate), inpatient services (82%), and hospital support teams (48%). High-income countries showed significant increase in all types of services (p < 0.001), while low-to-middle-income countries showed significant increase only for inpatient services. Central–Eastern European countries showed significant improvement in home care teams and inpatient services, while Western countries showed significant improvement in hospital support and home care teams. Home care was the most prominent service in Western Europe. Conclusion: Specialized service provision increased throughout Europe, yet ratios per 100,000 inhabitants fell below the EAPC recommendations. Western Europe ratios’ achieved half of the suggested services, while Central–Eastern countries achieved only a fourth. High-income countries and Western European countries account for the major increase. Central–Eastern Europe and low-to-middle-income countries reported little increase on specialized service provision.
- Advancing pediatric palliative care in a low-middle income country: an implementation study, a challenging but not impossible task(Springer, 2020) Desbrandes, F. (Francois); Cuervo-Suárez, M.I. (María Isabel); Gómez-García, W. (Wendy); Arias-Casais, N. (Natalia); Parra-Lara, L.G. (Luis Gabriel); Claros-Hulbert, A. (Angelica); García-Quintero, X. (Ximena)Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You” (TCY), in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017 and 2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.