Understanding palliative and end of life care access within a health ecosystem: An examination of the issues facing providers and service users

良好的姑息治疗可以提高患者临终时的生活质量，支持有尊严地死亡，减轻家庭照顾者的负担。此外，死亡地点与生活质量有关，亲人的舒适死亡可以改善丧亲之痛的福祉。人口老龄化加上非传染性疾病流行率的增加意味着到2040年，英格兰和威尔士的年死亡人数将增加27%。然而，只有一小部分医疗保健研究关注姑息治疗，超过三分之一的健康和福利委员会在评估当地人口的需求时没有考虑垂死者的需求。也许不足为奇的是，在满足足够的需求方面存在困难，更不用说高质量的姑息治疗了，四分之一的英国家庭无法获得他们需要的临终关怀

Good palliative care improves quality-of-life for patients at the end of life, supports dying with dignity, and alleviates some family caregiver burden Moreover, place of death is related to quality-of-life, and the comfortable death of a loved one improves the wellbeing of the bereaved Demand for palliative care will rise: an ageing population coupled with increasing prevalence of non-communicable diseases means annual deaths in England and Wales will increase by 27% by 20403. At the same time, the trend towards smaller and more fragmented families will lead to fewer familial caregivers changing the current place of death distribution pattern Yet, only a miniscule proportion of healthcare research focuses on palliative care and more than one thirdof health and wellbeing boards do not consider the needs of dying people when assessing the requirements of their local populations. It is perhaps unsurprising then that there is a struggle to meet the demands of adequate, let alone high-quality, palliative care, with 1 in 4 UK families unable to access the end of life care they need