智利姑息治疗需求的过去趋势和未来预测：经常可用的死亡注册表和人口数据的分析
Past trends and future projections of palliative care needs in Chile: analysis of routinely available death registry and population data
影响因子:8.30000
分区:医学1区 Top / 医学：内科1区
发表日期:2024 Sep 02
作者:
Javiera Leniz, Angélica Domínguez, Anna E Bone, Simon Etkind, Pedro E Perez-Cruz, Katherine E Sleeman
摘要
有姑息治疗需求的人数预计将在全球增加。智利最近针对患有严重和绝症的患者（包括非癌症状况）提出了普遍获得姑息治疗服务的立法。我们的目的是估计受严重健康相关痛苦影响的人数，并需要在智利姑息治疗，至2050年。我们使用了1997 - 2019年间智利注册的所有死亡的数据，以及1997 - 2050年的人口估计。我们使用Poisson回归来模拟通过年龄，性别和人口估计调整的死亡原因的过去趋势，从2021年到2050年的每个原因的死亡人数。我们在这些预测上应用了柳叶刀委员会对姑息治疗委员会的疼痛和疼痛减轻重量的投影委员会对这些预测的预测，以识别11个疾病的需求。 120）千人在2021年至209年（95％CI 198至223）2050年，增加了79％（IRR 1.79; 95％CI 1.78-1.80）。这种增加将由非癌症条件，尤其是痴呆症（IRR 2.9，95％CI 2.85-2.95）和心血管疾病（IRR 1.86，95％CI 1.83-1.89）驱动。到2050年，据估计需要姑息治疗的人中有50％将是非约束（预计不会在一年内死亡）。智利将经历姑息治疗需求的大幅度增加，尤其是对于患有痴呆症和其他非癌症患者而言。迫切需要改善高质量服务的可用性，扩大的临床医生培训和新的可持续护理模型，以确保普遍获得姑息治疗。
Abstract
The number of people with palliative care needs is projected to increase globally. Chile has recently introduced legislation for universal access to palliative care services for patients with severe and terminal illnesses, including non-cancer conditions. We aimed to estimate the number of people affected by serious health-related suffering and need for palliative care in Chile to 2050.We used data on all deaths registered in Chile between 1997-2019 and population estimates for 1997-2050. We used Poisson regression to model past trends in causes of death adjusted by age, sex and population estimates, to project the number of deaths for each cause from 2021 to 2050. We applied the Lancet Commission on Palliative Care and Pain Relief weights to these projections to identify decedents and non-decedents with palliative care needs.Population palliative care needs in Chile are projected to increase from 117 (95% CI 114 to 120) thousand people in 2021 to 209 (95% CI 198 to 223) thousand people in 2050, a 79% increase (IRR 1.79; 95% CI 1.78-1.80). This increase will be driven by non-cancer conditions, particularly dementia (IRR 2.9, 95% CI 2.85-2.95) and cardiovascular conditions (IRR 1.86, 95% CI 1.83-1.89). By 2050, 50% of those estimated to need palliative care will be non-decedents (not expected to die within a year).Chile will experience a large increase in palliative care needs, particularly for people with dementia and other non-cancer conditions. Improved availability of high-quality services, expanded clinician training and new sustainable models of care are urgently required to ensure universal access to palliative care.