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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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COUNTRY INFORMATION / LATVIA<br />

15,594 5.8 784 3.2 41 75<br />

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 />

Life expectancy at birth,<br />

total (years), 2016<br />

B<br />

PC SERVICES FOR ADULTS<br />

12 0.6<br />

2<br />

TOTAL<br />

l Hospital<br />

PC support<br />

teams<br />

17%<br />

l Home PC<br />

teams<br />

8%<br />

1<br />

9<br />

l Inpatient<br />

PC units<br />

<strong>in</strong> hospitals<br />

75%<br />

PC SERVICES<br />

PER 100,000<br />

INHABITANTS<br />

l PC services<br />

for adults<br />

<strong>in</strong> Latvia<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 />

Additional PC<br />

Services<br />

for Adults<br />

R Day care services -<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 />

40.9 mg<br />

l Average consumption<br />

<strong>in</strong> Latvia<br />

Average consumption<br />

<strong>in</strong> <strong>Europe</strong> [107 mg]<br />

National PC association<br />

NAME<br />

Children’s <strong>Palliative</strong> <strong>Care</strong> Society<br />

Bērnu paliatīvās aprūpes biedrība<br />

Other associations<br />

YES NO<br />

SINCE<br />

1998<br />

<strong>Palliative</strong> <strong>Care</strong> Association <strong>of</strong> Latvia<br />

Directory <strong>of</strong> services<br />

YES<br />

NO<br />

38<br />

RELEVANT REFERENCES ON PC DEVELOPMENT<br />

2 0<br />

0<br />

1<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 />

Vranken MJ, et al. Barriers<br />

to access to opioid<br />

medic<strong>in</strong>es: a review <strong>of</strong><br />

national legislation and<br />

regulations <strong>of</strong> 11 central<br />

and eastern <strong>Europe</strong>an<br />

countries. Lancet<br />

Oncol. 2016;17(1):e13-<br />

22.<br />

Centeno C, et al. The<br />

<strong>Palliative</strong> <strong>Care</strong> Challenge:<br />

Analysis <strong>of</strong> Barriers<br />

and Opportunities<br />

to Integrate <strong>Palliative</strong><br />

<strong>Care</strong> <strong>in</strong> <strong>Europe</strong> <strong>in</strong> the<br />

View <strong>of</strong> National Associations.<br />

J Palliat Med.<br />

2017;20(11):1195-1204.<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 />

Anda Jansone, Vilnis Sosars.<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 />

147

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