JMIR Publications

ABSTRACT

Background:

The aging population in the Global North is associated with an increased prevalence of multiple chronic diseases that would benefit from integrated palliative care. Often, the elderly reside in rural areas that lack access to comprehensive healthcare services. Therefore, it is vital to consider the effectiveness of healthcare systems and their ability to respond to the healthcare needs of this population, including access to palliative care services. Understanding palliative care program availability, care access, and palliative care systems characteristics are important to create useful health interventions in rural areas.

Objective:

This study aims to provide an international view of chronic health issues that the elderly face. Building on a study previously completed in Osona, Spain, a study exploring palliative care services offered in Southern Minnesota, United States will be carried out. Ultimately, findings from the study conducted in Spain will be compared to the findings in the United States, providing information and insights into strengths of each system and identification of areas for growth.

Methods:

This study will be performed using qualitative case study methodology. A framework for describing integrated palliative care systems developed after rigorous review of palliative care systems described in a wide body of literature will inform study methods. Using similar methodology as was used in the Spain study, palliative care offerings will be explored in a similarly sized rural area in Southern Minnesota. This will be accomplished by 1. reviewing available literature related to the Southern Minnesota Palliative Care System and 2. by identifying key providers in integrated palliative care systems who will be invited to participate in semi-structured interviews focusing on perceived gaps between ideal integrated palliative care system services with existing palliative care. In addition, the participants will be asked about complementary services and their perceptions of ethical issues and dilemmas that evolved during the COVID-19 pandemic.

Results:

Following approval from the ethical review of this protocol, data collection is anticipated to begin in the spring or summer of 2022 and is expected to take six months. Data collection will be followed by data analysis in fall 2022. Finally, the researchers plan to disseminate the findings in the spring of 2023.

Conclusions:

Studying a similarly sized but culturally and geographically different rural palliative care system in comparison to the completed Spain study will give insights into how integrated palliative care systems impact the chronically ill and elderly. Study findings will contribute to enhanced patient care, organizational improvements, policy change, and understanding the impact of different healthcare system models. In addition, new patient-centered care strategies will be identified by understanding the ethical dilemmas encountered by palliative care systems healthcare providers.