Improving care at the end-of-life is a growing global public health priority and an important aspect of people-centred health policies. In recent years, awareness about end-of-life care (EOLC) has climbed on the policy agenda and has led to discussions around the development and appropriateness of palliative care, life-sustaining care and social services in virtually all OECD countries. The COVID-19 pandemic has also exposed many pre-existing issues and raised new challenges regarding EOLC services and policies to improve people’s well-being at the end-of-life.
The OECD began working on EOLC in 2020, aiming to review how health systems in OECD countries are addressing EOLC and to identify useful practices and evidence-based strategies. A final report is to be released early 2022.
WHY IS END-OF-LIFE CARE IMPORTANT
People at all ages can benefit from receiving a high-quality EOLC. However, as populations are ageing, the need for EOLC is likely to increase. This is all the more important as more people are ageing with chronic and disabling conditions, and the largest increase has occurred among the oldest – people 80 years of age and older. In this scenario, the number of people dying of diseases that would benefit from palliative care and EOLC is forecasted to increase from 6.3 million in 2017 to 9.8 million in 2055, with a stabilising trend towards the end of the 21st century.
EOLC needs to be more people-centred. The place of care at the end-of-life is important for patients and their families, while also for governments and other stakeholders when it comes to planning and policy-making. Initial analysis of data in some OECD countries shows that hospitals are still the predominant place of death, accounting for more than 40% of deaths on average and up to 77% in some countries.
Percentage of people dying in hospital in 2017 (or latest year available) for 25 OECD countries
Source: OECD, Background paper for the End-of-Life Care Project (EOLC) – Expert Workshop 2020, unpublished; using data from Statcube, 2017, Agentschap zorg & gezondheid, 2017, Statistics Canada, 2020, Departamento de Estadisticas e información de Salud, 2017, INSEE, 2017, General statistical office - Genesis, 2020, Central Statistics Office, 2020, e-stat - Japan in statistics, 2020, Scharel LEHNERS, 2019, Palliative Care Council of New Zealand, 2014, Jorid Kalseth, 2017, Kostat, 2020, Office for National Statistics, 2020, CDC - Centre for Disease Control and Prevention, 2020, Broad et al., 2013.