Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia

By David Clark; Michael Wright et al. | Go to book overview

2
Epidemiological and policy
considerations

In this chapter we set out two groups of factors that have a crucial influence on the development of palliative care in both CEE and the CIS. We begin with a brief overview of epidemiological considerations and then examine some of the major policy factors shaping health care development, including levels of funding and modes of reimbursement. The material presented here therefore outlines the wider context in which palliative care developments across the region must be viewed.


Demographic and epidemiological overview

The 28 countries that make up this review vary enormously in size, geography and in the prevailing health status of their populations. The smallest country included is Estonia, with a population of just 1.3 million and the largest (more than 100 times greater) is the Russian Federation, with 145.4 million. Life expectancy for men is lowest in Russia (59.4) and for women is lowest in Tajikistan (64.7). The highest life expectancy for both men (71.9) and women (79.4) is found in Slovenia. Table 2.1 gives the population and life expectancy for all the countries of CEE and the CIS for the year 2000.

Age standardized death rates per 100,000 population (see Table 2.2) give a further insight into the well being of the population, though they are unavailable for some countries. Here, the highest rates (1,202.5), in Moldova, are double those of the lowest, in Slovenia (696.7). Concerning the disease group most identified with palliative care, age standardized death rates for cancer also show a steep gradient. Led by Hungary (219.4), Czech Republic (182.9) and Croatia (174.2), they are lowest in Azerbaijan (84.5), Kyrgyzstan (91.9) and Armenia (97.7).

-11-

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Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Series Editor’s Preface vii
  • Foreword ix
  • Acknowledgements xi
  • 1 - Introduction- Background, Aims and Methods of the Review 1
  • 2 - Epidemiological and Policy Considerations 11
  • 3 - Palliative Care Developments across the Region 18
  • 4 - Palliative Care Beacons 176
  • 5 - Conclusions and Recommendations 269
  • Index 292
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