Palliative Care in Latin America: Are We Making Any Progress? Assessing Development Over Time Using Macro Indicators

Area of Science:

• Palliative Care Research
• Health Services Research
• Global Health

Background:

• Monitoring palliative care development is crucial for identifying progress and challenges.
• Latin America has seen evolving palliative care landscapes requiring updated assessments.

Purpose of the Study:

• To report on the current status of palliative care development in Latin America.
• To introduce and apply the ALCP Index-II for measuring progress and enabling cross-country comparisons.
• To analyze trends in policy, education, access to medicines, and service provision.

Main Methods:

• Secondary analysis of data from the 2012 and 2020 Atlas of Palliative Care in Latin America.
• Development and application of the ALCP Index-II, incorporating z-scores for standardized indicator comparison.
• Ranking of 17 Latin American countries based on palliative care development levels (High, Moderate, Low).

Main Results:

• Increased national palliative care plans (29% to 59%) and medical school integration (4.2% to 15.4%).
• Modest increase in distributed opioid morphine equivalence (6.6 to 7.1 mg/capita) and services (1.5 to 2.6/million).
• Significant correlations found between service provision, medical school inclusion, morphine availability, and national plans. Uruguay, Chile, and Costa Rica showed highest development; heterogeneity increased.

Conclusions:

• Substantial progress in palliative care development across Latin America has been observed.
• The ALCP Index-II is a valuable tool for assessing and comparing palliative care development.
• Continued monitoring and strategic interventions are needed to address remaining disparities.