THE 2015 QUALITY OF DEATH INDEX - Lien Foundation Quality of Death... · THE 2015 QUALITY OF DEATH...
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THE 2015 QUALITY OF DEATH INDEX RANKING PALLIATIVE CARE ACROSS THE WORLD An Economist Intelligence Unit study, commissioned by the Lien Foundation KEY FINDINGS INFOGRAPHIC
Transcript of THE 2015 QUALITY OF DEATH INDEX - Lien Foundation Quality of Death... · THE 2015 QUALITY OF DEATH...
THE 2015 QUALITY OF DEATH INDEXRANKING PALLIATIVE CARE ACROSS THE WORLD
An Economist Intelligence Unit study, commissioned by the Lien Foundation
KEY FINDINGS INFOGRAPHIC
As governments across the world work to improve life for their citizens, they must also consider how to help them die well. The Economist Intelligence Unit has assessed the availability, affordability and quality of palliative care available to adults across 80 countries. Countries were scored out of 100 on 20 indicators in five categories:
Palliative and healthcare environment (20% weighting)Covers the general palliative andhealthcare framework
Human resources (20% weighting)Measures the availabilityand training of medical careprofessionals and support staff
Affordability of care (20% weighting)Assesses the availability of public funding for palliative care and the financial burden to patients
Community engagement (10% weighting)Measures the availability of volunteers and public awareness of palliative care
OVERALL RESULTS
Quality of care (30% weighting)Evaluates the presence of monitoring guidelines, the availability of opioids and the extent to which healthcare professionals and patients are partners in care
93.9
91.6
87.6
85.8
84.5
83.1
82.0
80.9
80.8
79.4
77.8
77.6
77.4
76.3
76.1
75.4
74.8
73.7
73.5
73.3
71.1
66.6
63.4
60.8
59.8
58.7
58.6
57.7
57.3
54.0
53.6
52.5
51.8
48.5
47.8
46.8
46.7
46.5
46.1
44.0
42.7
42.5
42.3
40.2
40.1
40.0
38.2
37.2
36.0
34.8
34.3
33.8
33.6
33.4
33.2
32.9
32.9
31.9
31.3
30.8
30.3
30.1
30.0
28.3
27.1
27.0
26.8
26.7
25.5
25.1
23.3
22.8
21.2
20.9
17.2
17.1
16.9
15.3
14.1
12.5
93.9
UNITED KINGDOM 1
AUSTRALIA 2
NEW ZEALAND 3
IRELAND 4
BELGIUM 5
TAIWAN 6
GERMANY 7
NETHERLANDS 8
USA 9
FRANCE 10
CANADA 11
SINGAPORE 12
NORWAY 13
JAPAN 14
SWITZERLAND 15
SWEDEN 16
AUSTRIA 17
SOUTH KOREA 18
DENMARK 19
FINLAND 20
ITALY 21
HONG KONG 22
SPAIN 23
PORTUGAL 24
ISRAEL 25
POLAND 26
CHILE 27
MONGOLIA 28
COSTA RICA 29
LITHUANIA 30
PANAMA 31
ARGENTINA 32
CZECH REPUBLIC 33
SOUTH AFRICA 34
UGANDA 35
CUBA 36
JORDAN 37
MALAYSIA 38
URUGUAY 39
ECUADOR 40
HUNGARY 41
BRAZIL 42
MEXICO 43
THAILAND 44
VENEZUELA 45
PUERTO RICO 46
TURKEY 47
RUSSIA 48
PERU 49
KAZAKHSTAN 50
GHANA 51
MOROCCO 52
INDONESIA 53
TANZANIA 54
SLOVAKIA 55
GREECE =56
EGYPT =56
VIETNAM 58
ZIMBABWE 59
SAUDI ARABIA 60
ZAMBIA 61
BULGARIA 62
KENYA 63
ROMANIA 64
SRI LANKA 65
MALAWI 66
INDIA 67
COLOMBIA 68
UKRAINE 69
ETHIOPIA 70
CHINA 71
BOTSWANA 72
IRAN 73
GUATEMALA 74
DOMINICAN REPUBLIC 75
MYANMAR 76
NIGERIA 77
PHILIPPINES 78
BANGLADESH 79
IRAQ 80
US
CANA
DA
CHIL
E
COST
A RI
CA
PANA
MA
ARGE
NTIN
A
CUBA
URUG
UAY
ECUA
DOR
BRAZ
IL
MEX
ICO
VENE
ZUEL
A
PUER
TO R
ICO
PERU
COLU
MBI
A
GUAT
EMAL
A
DOM
INIC
AN R
EPUB
LIC
OVERALL RESULTS
UK
IREL
AND
BELG
IUM
GERM
ANY
NETH
ERLA
NDS
FRAN
CE
NORW
AY
SWIT
ZERL
AND
SWED
EN
AUST
RIA
DENM
ARK
FINL
AND
ITAL
Y
SPAI
N
PORT
UGAL
POLA
ND
LITH
UANI
A
CZEC
H RE
PUBL
IC
HUNG
ARY
TURK
EY
RUSS
IA
KAZA
KHST
AN
SLOV
AKIA
GREE
CE
BULG
ARIA
ROM
ANIA
UKRA
INE
ISRA
EL
SOUT
H AF
RICA
UGAN
DA
JORD
AN
GHAN
A
MOR
OCCO
TANZ
ANIA
EGYP
T
ZIM
BABW
E
SAUD
I ARA
BIA
ZAM
BIA
KENY
A
MAL
AWI
ETHO
PIA
BOTS
WAN
A
IRAN
NIGE
RIA
IRAQ
AUST
RALI
A
NEW
ZEA
LAND
TAIW
AN
SING
APOR
E
JAPA
N
SOUT
H KO
REA
HONG
KON
G
MON
GOLI
A
MAL
AYSI
A
THAI
LAND
INDO
NESI
A
VIET
NAM
SRI L
ANKA
INDI
A
CHIN
A
MYA
NMAR
PHIL
IPPI
NES
BANG
LADE
SH
59.8
48.5
47.8
46.7
34.3
33.8
33.4
32.9
31.3
30.8
30.3
30.0
27.0
25.1
22.8
21.2
16.9
12.5
80.8
77.8
58.6
58.6
53.6
52.5
46.8
46.1
44.0
42.5
42.3
40.1
40.0
36.0
26.7
20.9
17.2
91.6
87.6
83.1
77.6
76.3
73.7
66.6
57.7
46.5
40.2
33.6
31.9
27.1
26.8
23.3
17.1
15.3
14.1
93.9
85.8
84.5
82.0
80.9
79.4
77.4
76.1
75.4
74.8
73.5
73.3
71.1
63.4
60.8
58.7
54.0
51.8
42.7
38.2
37.2
34.8
33.2
32.9
30.1
28.3
25.5
AMERICASEUROPE
ASIA-PACIFIC
MIDDLE EAST & AFRICA
Using World Bank definitions, the low income group of countries includes those that had 2013 GNI per capita of less than US$4,125; the middle income group includes those that had more than US$4,125 but less than US$12,746, and the high income group includes those that had more than US$12,746.
Low income
Rank out of 80 X
KEY High income
Middle income
32 4527 40 6831 43 7511 39 4929 42 749 36 46
52 6335 59 7251 61 77 8034 =56 7037 60 7325 54 66 18 586 38 7114 53 78 793 28 6712 44 762 22 65
10 205 16 248 19 30 334 15 237 17 261 13 21 =5648 695547 645041 62
PALLIATIVE CARE AROUND THE WORLD & CASE STUDIES
The biggest problem is that our healthcare systems aredesigned to provide acute care when what we need is chroniccare... That’s still the case almost everywhere in the world– Stephen Connor, senior fellow at the Worldwide Hospice Palliative Care Alliance
RESULTS BY GEOGRAPHY AND CASE STUDIES
Rank: 27Score: 58.6 Highest number of palliative care services in region and long-running national programme have greatly benefitted quality of care
•••
CHILEBest in Latin America
Rank: 1Score: 93.9 A leader in palliative care thanks to extensive integration into National Health Service and strong hospice movement, but improvements still needed as life expectancy grows
•••
UKWorld leader
Rank: 71Score: 23.3 Facing difficulties from slow adoption of palliative care and a rapidly ageing population
•••
CHINAChallenges ahead
Rank: 66Score: 27.0 Leading the way in children’s palliative care among less developed nations
•••
MALAWIThe kids are all right
Rank: 28Score: 57.7Led by Dr Odontuya Davaasuren, palliative care in Mongolia has transformed from almost non-existent to the best in the low-income countries bracket
•••
MONGOLIAA personal mission
Rank: 23Score: 63.4 Though many pockets of excellence existed before, eg in Catalonia, national strategy unified approach across 17 regional health systems and raised national standards
•••
SPAINStrategy is key
Rank: 6Score: 83.1 Ranked 1st in Asia, Taiwanese palliative care is widely available, affordable and compre-hensive
•••
TAIWANLeading the way
Rank: 34Score: 48.5Supported by government, religious and philanthropic funding, South Africa offers the best palliative care in Africa
•••
SOUTH AFRICARaising the profile
KEY80 - 95
60 - 80
40 - 60
20 - 40
Below 20
1. PALLIATIVE AND HEALTHCARE ENVIRONMENTIS A PALLIATIVE CARE FRAMEWORK IN PLACE?
2. HUMAN RESOURCESARE ENOUGH PALLIATIVE CARE PROFESSIONALS AVAILABLE?
High-income countries generally score better in this category but there are some outstanding performers in lower income groups, including Costa Rica and Mongolia. The presence of a robust and effective national policy is crucial to doing well in this category.
Palliative care is a stand-alone academic speciality in high-scoring countries in this category, such as Australia and the UK. A shortage of accredited courses and palliative care professionals restricts the availability of care in many developing countries.
92.3
88.2
87.9
86.1
81.4
78.0
75.5
74.0
72.2
71.6
71.6
71.4
71.2
70.2
69.4
67.5
66.0
62.6
62.4
62.1
61.1
59.6
57.5
54.0
52.6
52.2
51.5
51.3
50.7
49.4
49.4
47.4
46.2
45.4
43.2
42.6
42.3
42.1
41.9
41.7
41.6
41.6
39.8
39.8
39.5
37.1
36.3
36.1
35.4
35.1
34.4
34.0
33.8
31.3
31.0
30.0
28.8
27.9
27.5
27.0
25.9
25.8
25.1
24.4
23.0
22.5
22.3
22.1
21.3
21.0
19.7
19.6
18.8
17.9
12.8
11.6
11.6
11.5
85.2
84.8
84.1
81.7
79.6
78.9
77.8
76.7
71.0
69.4
67.6
66.4
64.8
62.2
61.2
60.9
58.4
57.5
56.7
55.5
53.5
52.1
51.9
51.3
51.2
50.5
50.5
50.4
44.8
44.6
42.2
41.7
41.4
39.7
39.3
38.0
38.0
37.8
37.7
37.4
37.3
37.1
37.0
37.0
34.9
34.7
33.6
33.4
33.2
33.1
32.1
32.0
31.0
30.9
30.1
28.1
27.6
26.7
25.8
24.5
23.7
22.7
22.5
22.5
22.2
21.8
21.5
21.2
21.1
19.9
19.0
16.8
14.5
12.6
10.3
9.6
8.5
6.1
5.5 4.0
1.34.1
UNITED KINGDOM 1
NETHERLANDS 2
AUSTRALIA 3
IRELAND 4
TAIWAN 5
USA 6
AUSTRIA 7
NEW ZEALAND 8
NORWAY 9
BELGIUM 10
GERMANY 11
SINGAPORE 12
SWITZERLAND 13
JAPAN 14
SPAIN 15
FRANCE 16
FINLAND 17
CANADA 18
ITALY 19
SOUTH KOREA 20
ISRAEL 21
COSTA RICA 22
CHILE 23
MONGOLIA 24
PANAMA 25
DENMARK =26
SWEDEN =26
HONG KONG 28
URUGUAY 29
PUERTO RICO 30
POLAND 31
SOUTH AFRICA 32
PORTUGAL 33
CUBA 34
JORDAN 35
BRAZIL =36
MALAWI =36
ZAMBIA 38
VENEZUELA 39
RUSSIA 40
ECUADOR 41
MALAYSIA 42
MEXICO =43
UGANDA =43
VIETNAM 45
TURKEY 46
KENYA 47
GHANA 48
PERU 49
TANZANIA 50
INDIA 51
THAILAND 52
SRI LANKA 53
INDONESIA 54
LITHUANIA 55
ZIMBABWE 56
HUNGARY 57
GREECE 58
ARGENTINA 59
CZECH REPUBLIC 60
UKRAINE 61
COLOMBIA 62
IRAN =63
SLOVAKIA =63
MOROCCO 65
NIGERIA 66
BOTSWANA 67
SAUDI ARABIA 68
CHINA 69
KAZAKHSTAN 70
BANGLADESH 71
ETHIOPIA 72
MYANMAR 73
BULGARIA 74
GUATEMALA 75
ROMANIA 76
PHILIPPINES 77
DOMINICAN REPUBLIC 78
EGYPT 79
IRAQ 80
AUSTRALIA 1
UNITED KINGDOM 2
GERMANY 3
IRELAND 4
NEW ZEALAND 5
CANADA 6
NORWAY 7
SINGAPORE 8
TAIWAN 9
FRANCE =10
SWEDEN =10
AUSTRIA 12
SOUTH KOREA 13
USA 14
SWITZERLAND 15
JAPAN 16
BELGIUM 17
FINLAND 18
DENMARK 19
HONG KONG 20
MONGOLIA 21
NETHERLANDS 22
ISRAEL 23
UGANDA 24
URUGUAY 25
CZECH REPUBLIC 26
ITALY 27
LITHUANIA 28
ARGENTINA 29
POLAND =30
JORDAN =30
CHILE 32
BRAZIL 33
MEXICO 34
ZAMBIA 35
SPAIN 36
PORTUGAL 37
HUNGARY 38
CUBA 39
MALAYSIA 40
COSTA RICA =41
PANAMA =41
VENEZUELA =43
UKRAINE =43
THAILAND 45
MOROCCO 46
GHANA 47
EGYPT 48
SAUDI ARABIA 49
MALAWI 50
ECUADOR 51
SLOVAKIA 52
COLOMBIA 53
ROMANIA 54
RUSSIA 55
SRI LANKA 56
TURKEY 57
NIGERIA 58
SOUTH AFRICA 59
KAZAKHSTAN 60
GREECE 61
ZIMBABWE 62
TANZANIA 63
DOMINICAN REPUBLIC 64
PUERTO RICO 65
PERU 66
INDIA 67
GUATEMALA 68
VIETNAM 69
CHINA 70
INDONESIA 71
BOTSWANA 72
KENYA 73
ETHIOPIA 74
PHILIPPINES 75
MYANMAR =76
BULGARIA =76
IRAN 78
IRAQ 79
BANGLADESH 80
3. AFFORDABILITY OF CARE IS PALLIATIVE CARE AFFORDABLE TO ALL?
4. QUALITY OF CAREIS A HIGH STANDARD OF PALLIATIVE CARE PROVIDED?
Government-funded healthcare systems fare well in this category, especially those bolstered by charitable funding. Australia, Belgium, Denmark, Ireland and the UK excel in this category, as does Cuba, while several lower-income countries often have pockets of excellence funded by charitable donations.
The UK leads the world in this category, which encompasses issues such as the availability of opioid analgesics, psychological support and the ability and willingness of doctors to involve patients in their own care and accommodate individual care choices. Mongolia is a stand-out among low-income countries.
100.0
100.0
100.0
100.0
100.0
87.5
87.5
87.5
87.5
87.5
87.5
87.5
87.5
87.5
87.5
87.5
85.0
82.5
82.5
82.5
82.5
77.5
77.5
77.5
75.0
75.0
75.0
75.0
75.0
70.0
70.0
70.0
70.0
70.0
70.0
65.0
65.0
65.0
65.0
62.5
62.5
60.0
60.0
57.5
57.5
57.5
55.0
55.0
52.5
52.5
52.5
52.5
52.5
50.0
50.0
47.5
45.0
42.5
42.5
40.0
40.0
40.0
40.0
40.0
37.5
37.5
37.5
37.5
35.0
35.0
32.5
30.0
30.0
27.5
27.5
27.5
22.5
17.5
12.5
100.0
97.5
96.3
95.0
93.8
92.5
91.3
90.0
90.0
90.0
90.0
90.0
87.5
87.5
86.3
83.8
83.8
83.8
83.8
81.3
81.3
80.0
80.0
78.8
76.3
75.0
73.8
70.0
67.5
65.0
63.8
60.0
60.0
57.5
56.3
53.8
50.0
47.5
47.5
47.5
43.8
42.5
41.3
40.0
40.0
40.0
37.5
36.3
36.3
35.0
33.8
33.8
33.8
31.3
30.0
30.0
30.0
28.8
26.3
26.3
26.3
26.3
23.8
21.3
21.3
20.0
18.8
18.8
16.3
15.0
13.8
13.8
13.8
12.5
11.3
10.0
7.5
6.3
6.3
0.0 3.8
AUSTRALIA =1
UNITED KINGDOM =1
IRELAND =1
BELGIUM =1
DENMARK =1
GERMANY =6
NEW ZEALAND =6
SINGAPORE =6
TAIWAN =6
SWEDEN =6
SOUTH KOREA =6
FINLAND =6
NETHERLANDS =6
ITALY =6
CUBA =6
PANAMA =6
JAPAN 17
USA =18
SWITZERLAND =18
HONG KONG =18
CHILE =18
CANADA =22
NORWAY =22
FRANCE =22
LITHUANIA =25
SPAIN =25
PORTUGAL =25
VENEZUELA =25
KAZAKHSTAN =25
URUGUAY =30
MEXICO =30
MALAYSIA =30
COSTA RICA =30
SAUDI ARABIA =30
ECUADOR =30
AUSTRIA =36
MONGOLIA =36
CZECH REPUBLIC =36
JORDAN =36
POLAND =40
THAILAND =40
RUSSIA =42
GREECE =42
ARGENTINA =44
SOUTH AFRICA =44
BULGARIA =44
HUNGARY =47
VIETNAM =47
ISRAEL =49
BRAZIL =49
MOROCCO =49
SRI LANKA =49
BOTSWANA =49
GHANA =54
PERU =54
IRAN 56
PUERTO RICO 57
ETHIOPIA =58
MYANMAR =58
MALAWI =60
COLOMBIA =60
TANZANIA =60
KENYA =60
IRAQ =60
SLOVAKIA =65
ROMANIA =65
CHINA =65
INDONESIA =65
UGANDA =69
DOMINICAN REPUBLIC =69
TURKEY 71
EGYPT =72
BANGLADESH =72
INDIA =74
GUATEMALA =74
PHILIPPINES =74
ZAMBIA 77
ZIMBABWE 78
UKRAINE 79
NIGERIA 80
UNITED KINGDOM 1
SWEDEN 2
AUSTRALIA 3
NEW ZEALAND 4
FRANCE 5
CANADA 6
BELGIUM 7
SINGAPORE =8
TAIWAN =8
NETHERLANDS =8
USA =8
SWITZERLAND =8
ITALY =13
AUSTRIA =13
FINLAND 15
DENMARK =16
GERMANY =16
JAPAN =16
NORWAY =16
SOUTH KOREA =20
HONG KONG =20
IRELAND =22
PORTUGAL =22
SPAIN 24
ISRAEL 25
ARGENTINA 26
POLAND 27
CZECH REPUBLIC 28
LITHUANIA 29
COSTA RICA 30
SOUTH AFRICA 31
CHILE =32
MONGOLIA =32
TURKEY 34
UGANDA 35
EGYPT 36
PUERTO RICO 37
PANAMA =38
MALAYSIA =38
HUNGARY =38
ECUADOR 41
INDONESIA 42
PERU 43
JORDAN =44
BULGARIA =44
ZIMBABWE =44
CUBA 47
THAILAND =48
ROMANIA =48
TANZANIA 50
URUGUAY =51
BRAZIL =51
SLOVAKIA =51
MEXICO 54
RUSSIA =55
MOROCCO =55
KENYA =55
GHANA 58
KAZAKHSTAN =59
VIETNAM =59
ETHIOPIA =59
INDIA =59
GREECE 63
VENEZUELA =64
GUATEMALA =64
UKRAINE 66
COLOMBIA =67
ZAMBIA =67
CHINA 69
NIGERIA 70
BOTSWANA =71
IRAN =71
DOMINICAN REPUBLIC =71
SAUDI ARABIA 74
MYANMAR 75
PHILIPPINES 76
BANGLADESH 77
SRI LANKA =78
MALAWI =78
IRAQ 80
The public has a well of fear, anger and distrust about the care they will receive and how they and their families will die. And the hard truth is that this is well founded.- Ira Byock, executive director, Providence Institute for Human Caring
5. COMMUNITY ENGAGEMENTIS THERE DISCUSSION AND AWARENESS OF END-OF-LIFE CHOICES?
Public awareness of palliative care and availability of volunteer workers tend to go hand in hand in richer countries, although some developing countries—such as Uganda—have long had public and philanthropic commitments to improving awareness and standards of care.
100.0
100.0
92.5
92.5
82.5
82.5
82.5
82.5
75.0
75.0
75.0
75.0
75.0
65.0
57.5
57.5
57.5
57.5
57.5
57.5
57.5
50.0
50.0
50.0
50.0
50.0
42.5
42.5
42.5
42.5
42.5
42.5
40.0
40.0
40.0
40.0
35.0
32.5
32.5
32.5
32.5
32.5
32.5
32.5
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
25.0
17.5
17.5
17.5
17.5
17.5
17.5
17.5
17.5
17.5
17.5
17.5
7.5
0.0
0.0
0.0
NEW ZEALAND =1
BELGIUM =1
UNITED KINGDOM =3
FRANCE =3
TAIWAN =5
GERMANY =5
JAPAN =5
IRELAND =5
AUSTRALIA =9
CANADA =9
NETHERLANDS =9
USA =9
NORWAY =9
SOUTH KOREA 14
SWITZERLAND =15
ITALY =15
AUSTRIA =15
FINLAND =15
DENMARK =15
POLAND =15
UGANDA =15
SINGAPORE =22
PORTUGAL =22
COSTA RICA =22
ZIMBABWE =22
BRAZIL =22
SWEDEN =27
ISRAEL =27
CHILE =27
MONGOLIA =27
SLOVAKIA =27
UKRAINE =27
SPAIN =33
SOUTH AFRICA =33
JORDAN =33
ZAMBIA =33
HUNGARY 37
HONG KONG =38
ARGENTINA =38
PANAMA =38
INDONESIA =38
TANZANIA =38
GREECE =38
VENEZUELA =38
CZECH REPUBLIC =45
LITHUANIA =45
EGYPT =45
PUERTO RICO =45
MALAYSIA =45
ECUADOR =45
PERU =45
THAILAND =45
URUGUAY =45
MEXICO =45
RUSSIA =45
MOROCCO =45
KENYA =45
KAZAKHSTAN =45
INDIA =45
GUATEMALA =45
CHINA =45
NIGERIA =45
PHILIPPINES =45
SRI LANKA =45
MALAWI =45
TURKEY =66
BULGARIA =66
CUBA =66
ROMANIA =66
GHANA =66
VIETNAM =66
ETHIOPIA =66
COLOMBIA =66
SAUDI ARABIA =66
BANGLADESH =66
IRAQ =66
IRAN 77
BOTSWANA =78
DOMINICAN REPUBLIC =78
MYANMAR =78
Using World Bank definitions, the low income group of countries includes those that had 2013 GNI per capita of less than US$4,125; the middle income group includes those that had more than US$4,125 but less than US$12,746, and the high income group includes those that had more than US$12,746.
Low income
Rank out of 80 X
KEY High income
Middle income
The EIU also analysed the need (or “demand”) of each country for palliative care. The demand analysis is based on three factors: • Burden of diseases for which palliative care is necessary (60% weighting)• Old-age dependency ratio (20% weighting)• Speed of ageing of the population from 2015-2030 (20% weighting)
Mapping demand against the overall Quality of Death Index score (which shows the “supply” of palliative care) reveals where the gaps between the two are most pressing—for those countries in the bottom-right corner of the following chart.
Go to http://bit.ly/qualityofdeath2015 to download a white paper on the 2015 Quality of Death Index, which includes a detailed methodology. An interactive Excel workbook of the Index and summaries of the status of palliative care in all 80 countries included in the Index are also available.© The Economist Intelligence Unit 2015
Commissioned by
DEMAND IS SET TO RISE IN DEVELOPING COUNTRIES DUE TO:
Demand
Good
pro
visi
onQu
alit
y of
Dea
th In
dex
scor
e (S
uppl
y)
Low demand for palliative care High demand for palliative care
S
POLAND
SPAINPORTUGAL
FINLANDSWEDEN
FRANCE
NORWAYSINGAPOREJAPAN
HONG KONG
ISRAELCHILE
TAIWAN
MONGOLIA
RUSSIA
ARGENTINA
JORDAN
PANAMA
MALAYSIA
MEXICO
VENEZUELA
PERU
TANZANIAGHANA
KENYA
INDIA
GUATEMALA
NIGERIA
BANGLADESH
ETHIOPIAMALAWI
IRAN
SRI LANKA
MYANMAR
IRAQ
PHILLIPINE
UGANDA
PUERTORICO
BRAZILECUADOR
THAILAND
INDONESIAMORROCO
EGYPTZAMBIA
KAZAKHSTAN
SAUDIARABIA
VIETNAMZIMBABWE
DOMINICANREPUBLIC
COLOMBIA
GREECE
CHINA
HUNGARY
CUBASOUTH AFRICA
TURKEY
SLOVAKIA
ROMANIA
UKRAINE
BULGARIA
BOTSWANA
URUGUAY
LITHUANIA
COSTA RICA
SOUTH KOREA
US
BELGIUM
UK
SWITZERLAND
GERMANY
NEW ZEALAND IRELAND
CANADA
AUSTRIADENMARK
ITALY
NETHERLANDS
AUSTRALIA
CZECHREPUBLIC
Poor
pro
visi
on
Largerpopulations
Populationsageing faster
Increasing incidence of non- communicable diseases
