EAPC Atlas of Palliative Care in Europe 2019
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need. Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
Conclusion: PC health policies developed in recent years have promoted vigorous development across Europe. Preliminary data on the integration of PC into different fields are encouraging though inequalities between countries and sub-regions persist. Further comparative analysis exploring factors leading to uneven progress may inform strategies to provide PC for all people in need.
Per land is de stand van zaken van de (kinder)palliatieve zorg weergegeven.
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Gross Domestic Product<br />
per capita (US$), 2017<br />
Health expenditure<br />
(% <strong>of</strong> GDP), 2015<br />
Health expenditure<br />
per capita, PPP (US$)<br />
Physicians per 1,000<br />
<strong>in</strong>habitants, 2014<br />
Human Development<br />
Index Rank<strong>in</strong>g, <strong>2019</strong><br />
COUNTRY INFORMATION / ESTONIA<br />
19,705 6.5 1,112 3.3 30 78<br />
Life expectancy at birth,<br />
total (years), 2016<br />
B<br />
PC SERVICES FOR ADULTS<br />
18 1.4<br />
2 1<br />
TOTAL<br />
l Hospital<br />
PC support<br />
teams<br />
11%<br />
l Inpatient<br />
PC units<br />
<strong>in</strong> hospitals<br />
6%<br />
PC SERVICES<br />
PER 100,000<br />
INHABITANTS<br />
l PC services<br />
for adults<br />
<strong>in</strong> Estonia<br />
PC services<br />
for adults <strong>in</strong><br />
<strong>Europe</strong> (median)<br />
[0.8/100,000<br />
<strong>in</strong>hab.]<br />
15 l Home PC Additional PC R Day care services -<br />
teams<br />
83%<br />
Services<br />
for Adults<br />
R Volunteer-led hospices -<br />
MEDICINES<br />
PROFESSIONAL ACTIVITY<br />
Opioid consumption per capita <strong>in</strong> morph<strong>in</strong>e equivalent,<br />
exclud<strong>in</strong>g methadone, 2017<br />
25.1 mg<br />
l Average consumption<br />
<strong>in</strong> Estonia<br />
Average consumption<br />
<strong>in</strong> <strong>Europe</strong> [107 mg]<br />
National PC association<br />
NAME<br />
Pallium<br />
Pallium<br />
Other associations<br />
YES NO<br />
SINCE<br />
2010<br />
YES NO<br />
Directory <strong>of</strong> services<br />
YES<br />
NO<br />
12<br />
9<br />
4<br />
0<br />
0<br />
Morph<strong>in</strong>e Code<strong>in</strong>e Fentanyl Oxycodone Hydromorph<strong>in</strong>e<br />
General availability <strong>of</strong> oral morph<strong>in</strong>e (<strong>in</strong>mediate release)<br />
Opioid prescription requirements<br />
Special prescription form<br />
Prescription limits<br />
Patient registration as an opioid user<br />
Pr<strong>of</strong>essionals allowed to prescribe<br />
YES NO<br />
YES NO<br />
Few weeks<br />
YES NO<br />
RELEVANT REFERENCES ON PC DEVELOPMENT<br />
Vranken MJM et al.<br />
Barriers to access to<br />
opioid medic<strong>in</strong>es for<br />
patients with opioid<br />
dependence: a review<br />
<strong>of</strong> legislation and regulations<br />
<strong>in</strong> eleven central<br />
and eastern <strong>Europe</strong>an<br />
countries. Addiction.<br />
Jun;112(6):1069-1076.<br />
Suija K et al . <strong>Palliative</strong><br />
home care for cancer<br />
patients <strong>in</strong> estonia.J<br />
Pa<strong>in</strong> Symptom Manage.<br />
2012 43(4):e4-5.<br />
Centeno C, et al. Coverage<br />
and development<br />
<strong>of</strong> specialist palliative<br />
care services across the<br />
World Health Organization<br />
<strong>Europe</strong>an Region<br />
(2005-2012): Results<br />
from a <strong>Europe</strong>an Association<br />
for <strong>Palliative</strong> <strong>Care</strong><br />
Task Force survey <strong>of</strong> 53<br />
Countries. Palliat Med.<br />
2016;30(4):351-62.<br />
KEY INFORMANTS<br />
Only specialists<br />
All physicians<br />
Nurses tra<strong>in</strong>ed <strong>in</strong> PC<br />
Pille Sillaste, Kaiu Suija.<br />
See more <strong>in</strong>formation<br />
<strong>in</strong> onl<strong>in</strong>e version<br />
<strong>EAPC</strong> <strong>Atlas</strong> <strong>of</strong> <strong>Palliative</strong> <strong>Care</strong> <strong>in</strong> <strong>Europe</strong><br />
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