Palliative care services and settings: comparing care

The focus of this project was to review palliative care literature on services and settings to establish whether they meet needs of patients and expectations of care providers. In the first part of this two-part article, issues such as the actual and preferred location of death, the quality of care given and comparison of different care settings providing palliative care are identified. The studies were fairly consistent in the information provided regarding care for the terminally ill patient. Primarily, hospice and hospice-based home care teams emerged as the providers of best care. The literature highlighted the fact that dying is a complex process which hinders researchers by making measurement difficult; consequently research assessing the effectiveness of palliative care has been limited. Since palliative care is multi-dimensional, it cannot be easily encompassed by one means of assessment and results gained in one care setting are not necessarily applicable to others. Given the variety of services available, purchasers, providers and users need to know for which patients hospice is most effective and which care models work best. There is therefore a need to design and carry out studies which advance the understanding of dying and the care that will influence this process.