Approximately 29% of Australians live in regional, rural and remote areas. These Australians face unique healthcare challenges, have poorer health and welfare outcomes, and reduced access to subacute health care services - including palliative care - compared to Australians living in urban settings. These patients are recognised as an underserved population requiring innovative interventions, funding, and policy change to meet their needs at end-of-life.
Palliative and end-of-life care aims to improve the quality of life of people, their families and carers facing life-limiting illness through the prevention and amelioration of suffering. Each person has a right to receive treatment across the disease trajectory.
Australians living in country areas have shorter life expectancy, higher levels of disease and injury, and reduced access to healthcare services. Mortality rates increase with geographical remoteness. For those with life-limiting illnesses, many would like to spend their last weeks at home or in a healthcare setting near to family and friends, with the support of local healthcare professionals.
The primary aim is to identify effective evidenced-based delivery models of palliative and end-of-life care for people living in rural areas of high-income countries.
This systematic mixed studies review is guided by the PRISMA guidelines. Data source: PubMed, Ovid MEDLINE and CINAHL databases, searched from January 1990 – January 2020, and the CareSearch evidence search filters have been utilised. Eligible studies include papers reporting empirical data of palliative and end-of-life care service delivery for adults and children living in rural, regional or remote areas of high-income countries.
Preliminary results have yielded heterogenous approaches to care including telehealth; home-visiting models; GP-led or nurse-led models; and volunteer-based care.
Implications for Practice
This review will inform a Western Australian study aimed at improving rural, regional and remote palliative and end-of-life care service delivery by identifying, developing and implementing novel solutions to local problems and mobilising state-wide services.