ABSTRACT
Palliative care is increasingly recognized as a public health concern because the problems faced by patients and those important to them, such as their families, occur universally and are a substantial burden of illness and cost to societies. Moreover, need is likely to increase markedly in the future. Societies are facing an 87% increase in the need for palliative care globally by 2060, much of this among older people. There are inequities in access to palliative care, by social factors, by diagnosis, age, region, and personal characteristics. Despite the World Health Alliance declaration in 2014 that palliative care should be part of universal health-care coverage, and progress has been made toward this, there is continued unmet need and many miss out on the best in care. This is set in the context where care at the end of life comprises a large component of health-care resources. High-quality and randomized trial evidence reveals that palliative care services improve outcomes and are effective, cost effective, and high value (outcomes/costs). 1–4 Services will need to evolve to respond to the public health challenges created by the changing populations in need of palliative care in the future; this will require further development and research. Appropriate economic measures are also needed.
