2006
Programa de Cuidados Paliativos Gobierno de Cataluña (Palliative Care Program, Department of Health, Government of Catalonia)
Barcelona, Spain
The Catalonia WHO demonstration project was designed in 1989 and started to implement in 1990 due to cooperation between the Catalan Department of Health and the WHO Cancer Unit, initiated formal cooperation to design and develop a WHO demonstration project on the implementation of palliative care in our region.
The most important principles were to consider good palliative care as a right for every person who needed it, and palliative care services as a standard available service inserted in the mainstream of the regional public health care system, with a special focus on community and home care. The basic aims were to achieve public coverage for cancer and noncancer patients, accessibility, equity, quality (effectiveness, efficiency), and reference for other ministries of Health as a rational way of planning palliative care.
During this period of time, a wide range of resources have been implemented in all of the levels of the Health Care System.
The results in 2005 include the care of 21,400 patients (59% cancer and 41% non-cancer), with a coverage for cancer of 79.4%, an estimated range of coverage for non-cancer of 25.0 to 56.5%, and more than 95% of geographical coverage.
The specialist resources include 63 Palliative Care Units , with 552 total beds (79 /million inhabitants), 34 Hospital Support Teams, 70 Home Care Support Teams , 16 Specialist reference Outpatient’s clinics and specific teams for pediatrics and aids.
The overall number of resources is 183, and there are 140 full time doctors devoted to palliative care. During this years, near 200.000 patients and their families have been attended.
Fourteen districts have comprehensive networks for palliative care.
The strong opioid consumption has increased from the initial figure of 3.5 kg/million inhabitants by 1989 to 21 in 2004, and with the introduction of new opioids.
There are results in efficacy in symptom control, change in the use of resources, increase of opioid consumption, and satisfaction of patients and families. Results in cost-efficiency are striking, due to the radical change on the pattern of use of acute and emergency beds.
XGB. Barcelona 05 Marzo 2007.
