Availability of palliative care cancer services in Brazil

It has been a difficult task to define the number of patients in need of palliative care, the necessary resources and the specific criteria to structure and adapt palliative care services in Brazil. Until now the quantification of palliative care needs in our country has been estimated in an isolated way and based on international experiences. However, there are doubts about the applicability of these parameters considering the population and territorial dimensions, as well as the regional diversities. The analysis of the population morbidity and mortality profiles is necessary to the establishment of possible parameters to be employed for the assistance in palliative care, such as hospital admissions for the treatment of clinical intercurrences of cancer patients. Aims: To develop estimates of the current situation, the coverage and the need for palliative care services. Identify the number of hospitals that admitted potential patients with palliative care needs and the number of hospital beds used for the hospitalizations. Methods: Retrospective and observation analysis of the hospital admission registers of cancer patients were performed to verify the number of cancer patients in need of palliative care and the number of clinic hospital beds used yearly to admit these patients. Data on hospital admission of cancer patients, like average length of stay and hospital mortality were used. Results: Between 2008 and 2016, were registered in the Hospital Information System of SUS (SIH-SUS) 1,7 million hospitalizations for treatment of clinical intercurrence of cancer patient. These admissions were identified on 3,374 different health units around the country. An average of 91% of all hospitalizations for treatment of clinical intercurrence of cancer patient were registered in 380 hospitals Conclusions: To improve the quality of life, relieve physical suffering, cater for the psychological, spiritual and social needs of people with severe and advanced diseases, as well as to provide support to families and caregivers, it is indispensable to consider the existing models of health care. The inclusion or expansion of palliative attention meets the size, nature and severity of the needs of cancer patients

Palliative Care in Brazil: With a View to Future Needs?

Background: Chronic non-communicable diseases (CNCD) constitute a health problem of growing magnitude in Brazil, leading concerns, to the Ministry of Health (MOH), about the care of persons with chronic conditions (due to advanced diseases), multiple harms to health, convalescents and in need of long-term care, requiring continuous assistance, physical and functional rehabilitation. However, few data exist on the size of the population potentially in need of palliative care in Brazil. Aim: this study is to estimate the size of the Brazilian population that could benefit from palliative care across 26 federated states and the Federal District. Design: this is a cross-sectional study, using national death certificate and hospital admission data. Brazilian death registration and hospital admission data from 1st of January to 31st of December 2014 were analyzed and compared with estimation methods of Rosenwax and Murtagh. Setting/participants: all adults (≥ 15 years old) who died in the period of 1st of January to 31st of December 2014 in Brazil. Results: the proportion of individuals who died from diseases that indicate palliative care needs at the end of life ranged from 24.6% to 85.2%.   Keywords: palliative care; estimating population; chronic non-communicable diseases; cancer; health planning