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 (IPC) 1. 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 (PC) services. Understanding palliative care program availability, care access, and Palliative Care Systems (PCS) 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. This study will compare two culturally and geographically different PCS's, one in Osona, Catalonia, Spain, and the second in Southern Minnesota, United States.

Methods:

This study will be performed using qualitative case study methodology. The initial phase consisted of a literature search to identify a framework for describing Integrated Palliative Care Systems (IPCS) 2. In the second phase, a medium-sized rural area in Southern Minnesota will be compared with a similarly sized rural area in Catalonia, Spain. Finally, critical providers in PCS and IPCS will be identified and invited to participate in semi-structured interviews. These interviews will focus on the perceived gap between ideal IPCS care services with existing PCS/IPCS services. In addition, the participants will be asked about their perceptions of ethical issues and dilemmas that evolved during the COVID-19 pandemic.

Results:

Timeline: After an ethical review of this protocol, data collection is anticipated to begin in the spring 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:

Conclusions:

Studying two similarly sized but culturally and geographically different rural PCS's will give insights into how IPCS impacts the chronically ill and elderly. This 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 PCS healthcare providers. Clinical Trial: Not applicable