Presented by: Teresa Burgess
The complexity of the provision of end-of-life care for people with chronic disease is frequently underestimated and there is often an assumption that people with advanced chronic disease should be referred to palliative care services, with little clarity about when this should occur, nor whether this type of care best meets their needs. This presentation will discuss the results of research undertaken in Australia to identify how such care is currently provided and how future end-of-life models of care can be developed.
We used a Health Policy and Systems Research (HPSR) methodology, incorporating systems thinking and complexity theory, to explore health service dimensions such as policy, planning, management and organisation, as well as individual patient experiences.
We identified the importance of both an individual, person centred model of care based in primary care using a whole of system approach and a concurrent public health focused approach incorporating health promotion strategies such as community based education programs; community discussions around appropriate end-of-life care and the systematic identification of people who might benefit from end-of-life care. A priority should be the development of partnerships between communities and health service providers to inform the development of these models of care at the individual, primary care and public health levels. This requires reform of the structure and funding of primary care and the provision of incentives for quality end-of-life care. Above all, a shared vision of what end-of-life care in chronic disease should look like must be developed across the acute, primary care and community sectors.