The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach
Abstract Background Palliative care aims to maintain quality of life and offer treatment and person-centred care options for people with serious end-stage illnesses and their families. The purpose of this exploratory study was to compare the statutory coverage and access to palliative care for adult...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12904-025-01831-1 |
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| author | Nathan Shuftan Mark Dayan Sarah Scobie Bee Wee Antoniya Dimova Elka Atanasova Liubove Murauskiene Coralie Gandré Zeynep Or Gonçalo Figueiredo Augusto Triin Habicht Kristina Köhler Kristiina Kahur Bertil Axelsson Madelon Kroneman Judith de Jong Anke de Veer Wanda Bemelmans Chantal Pereira Ajay Aggarwal Joanna Davies Ewout van Ginneken Dimitra Panteli |
| author_facet | Nathan Shuftan Mark Dayan Sarah Scobie Bee Wee Antoniya Dimova Elka Atanasova Liubove Murauskiene Coralie Gandré Zeynep Or Gonçalo Figueiredo Augusto Triin Habicht Kristina Köhler Kristiina Kahur Bertil Axelsson Madelon Kroneman Judith de Jong Anke de Veer Wanda Bemelmans Chantal Pereira Ajay Aggarwal Joanna Davies Ewout van Ginneken Dimitra Panteli |
| author_sort | Nathan Shuftan |
| collection | DOAJ |
| description | Abstract Background Palliative care aims to maintain quality of life and offer treatment and person-centred care options for people with serious end-stage illnesses and their families. The purpose of this exploratory study was to compare the statutory coverage and access to palliative care for adult services for people with cancer in 8 European countries using a vignette approach. Methods We used a patient vignette to examine coverage and access to palliative care services across Europe. The palliative care vignette describes a pathway based on guidance for best practices of palliative care patients with incurable cancer. The surveys accompanying the vignette were completed by health services researchers knowledgeable on palliative care, practitioners, government officials, or teams consisting of a health systems expert working together with practitioners. Results Completed vignettes were received from 8 countries: Bulgaria, Estonia, France, Lithuania, the Netherlands, Portugal, Sweden and England. Services provided for palliative care envisioned in the vignette’s pathway are, generally, covered by the statutory health systems. However, in some countries cost sharing exists for hospital stays, certain medicines and medical aids. Furthermore, coverage of social and financial assessments, home equipment and financial advice varied in nearly every country. Travel times to and availability of palliative care specialists were identified as challenges across nearly all countries. Organizational barriers, societal stigmas and knowledge gaps about what palliative care entails were also found to be areas in need of improvement. Conclusions The comparative research presented provides further insight how countries organise palliative care, how services are offered and what levels of access exist around Europe. Our study showed differences in the scope of coverage of and access to the care options in the vignette. While responses showed countries have basic levels of coverage and access to services provided, there were variations, such as availability of specialists or the extent travel and waiting times influence care delivery. Settings where patients receive services also varied. As the need for palliative care grows in the future, health ministries and insurers should be increasingly concerned with how to guarantee coverage of and access to this care, as well as aware of best practices among countries facing similar challenges. |
| format | Article |
| id | doaj-art-e3ffccbbe6cd4629b46813009328f4fc |
| institution | DOAJ |
| issn | 1472-684X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj-art-e3ffccbbe6cd4629b46813009328f4fc2025-08-20T03:06:41ZengBMCBMC Palliative Care1472-684X2025-07-0124111110.1186/s12904-025-01831-1The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approachNathan Shuftan0Mark Dayan1Sarah Scobie2Bee Wee3Antoniya Dimova4Elka Atanasova5Liubove Murauskiene6Coralie Gandré7Zeynep Or8Gonçalo Figueiredo Augusto9Triin Habicht10Kristina Köhler11Kristiina Kahur12Bertil Axelsson13Madelon Kroneman14Judith de Jong15Anke de Veer16Wanda Bemelmans17Chantal Pereira18Ajay Aggarwal19Joanna Davies20Ewout van Ginneken21Dimitra Panteli22Department of Healthcare Management, Technische Universität BerlinNuffield TrustNuffield TrustNuffield Department of Medicine, University of OxfordMedical University of VarnaMedical University of VarnaDepartment of Public Health, Faculty of Medicine, Institute of Health Sciences, Vilnius UniversityInstitute for Research and Information in Health Economics (IRDES)Institute for Research and Information in Health Economics (IRDES)NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Rua da JunqueiraWHO Barcelona Office for Health Systems FinancingWHO Country OfficeHC Management Consulting LtdDepartment of Radiation Sciences, University Hospital of UmeåNivel, Netherlands Institute for Health Services ResearchNivel, Netherlands Institute for Health Services ResearchNivel, Netherlands Institute for Health Services ResearchNivel, Netherlands Institute for Health Services ResearchNetherlands Comprehensive Care Organisation (IKNL)King’s College London, Guy’s Campus George’s University NHS Foundation TrustEuropean Observatory On Health Systems and Policies, WHO European Centre for Health Policy, Eurostation (Office 07C020), Place Victor Horta/Victor HortapleinEuropean Observatory On Health Systems and Policies, WHO European Centre for Health Policy, Eurostation (Office 07C020), Place Victor Horta/Victor HortapleinAbstract Background Palliative care aims to maintain quality of life and offer treatment and person-centred care options for people with serious end-stage illnesses and their families. The purpose of this exploratory study was to compare the statutory coverage and access to palliative care for adult services for people with cancer in 8 European countries using a vignette approach. Methods We used a patient vignette to examine coverage and access to palliative care services across Europe. The palliative care vignette describes a pathway based on guidance for best practices of palliative care patients with incurable cancer. The surveys accompanying the vignette were completed by health services researchers knowledgeable on palliative care, practitioners, government officials, or teams consisting of a health systems expert working together with practitioners. Results Completed vignettes were received from 8 countries: Bulgaria, Estonia, France, Lithuania, the Netherlands, Portugal, Sweden and England. Services provided for palliative care envisioned in the vignette’s pathway are, generally, covered by the statutory health systems. However, in some countries cost sharing exists for hospital stays, certain medicines and medical aids. Furthermore, coverage of social and financial assessments, home equipment and financial advice varied in nearly every country. Travel times to and availability of palliative care specialists were identified as challenges across nearly all countries. Organizational barriers, societal stigmas and knowledge gaps about what palliative care entails were also found to be areas in need of improvement. Conclusions The comparative research presented provides further insight how countries organise palliative care, how services are offered and what levels of access exist around Europe. Our study showed differences in the scope of coverage of and access to the care options in the vignette. While responses showed countries have basic levels of coverage and access to services provided, there were variations, such as availability of specialists or the extent travel and waiting times influence care delivery. Settings where patients receive services also varied. As the need for palliative care grows in the future, health ministries and insurers should be increasingly concerned with how to guarantee coverage of and access to this care, as well as aware of best practices among countries facing similar challenges.https://doi.org/10.1186/s12904-025-01831-1Palliative careCoverageAccessCost-sharingBenefit packageFinancial protection |
| spellingShingle | Nathan Shuftan Mark Dayan Sarah Scobie Bee Wee Antoniya Dimova Elka Atanasova Liubove Murauskiene Coralie Gandré Zeynep Or Gonçalo Figueiredo Augusto Triin Habicht Kristina Köhler Kristiina Kahur Bertil Axelsson Madelon Kroneman Judith de Jong Anke de Veer Wanda Bemelmans Chantal Pereira Ajay Aggarwal Joanna Davies Ewout van Ginneken Dimitra Panteli The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach BMC Palliative Care Palliative care Coverage Access Cost-sharing Benefit package Financial protection |
| title | The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach |
| title_full | The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach |
| title_fullStr | The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach |
| title_full_unstemmed | The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach |
| title_short | The variation of coverage and access to palliative care for cancer patients in eight European countries: an exploratory vignette approach |
| title_sort | variation of coverage and access to palliative care for cancer patients in eight european countries an exploratory vignette approach |
| topic | Palliative care Coverage Access Cost-sharing Benefit package Financial protection |
| url | https://doi.org/10.1186/s12904-025-01831-1 |
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