End-of-Life Care : An International Perspective

Student thesis: Doctoral Thesis


The number of people who are dying from serious chronic diseases is
rising in many countries across the world. These people typically
experience a slow but steady progression of disease characterised by
multiple and complex physical, psychosocial, and spiritual problems
for which they require continuous care until death. The delivery of
high-quality end-of-life care is an important challenge for public
health due to the large number of people who need it and its impact
on health care costs. For this dissertation, Lara Pivodic carried out
cross-national and population-based analyses to study the provision
of end-of-life care by different care providers, the locations in which
people receive end-of-life care, and the locations in which they die.
The analyses are based on data obtained through epidemiological
surveillance networks in four countries, a retrospective survey of
bereaved relatives in the United Kingdom, and an analysis of death
certificates in 14 countries.
This dissertation gives insight into the involvement of general
practitioners and specialist palliative care teams in the care people
receive in the last three months of life, overburden in family carers,
hospitalisations and other transitions between care settings in the last
three months of life, and the place of death of people in potential
need of palliative care. The findings of this dissertation provide an
important population-based evidence base for the formulation of
national health policies to ensure policies to ensure an appropriate provision of highquality-end-of-life care.

Date of Award16 Dec 2015
Original languageEnglish
Awarding Institution
  • Vrije Universiteit Brussel
SupervisorLuc Deliens (Promotor), Koen Pardon (Promotor), Lieve Van den Block (Promotor), Dirk Devroey (Jury), Liesbeth Borgermans (Jury), Ellen Gorus (Jury), Sheila Payne (Jury), An De Sutter (Jury) & Guido Van Hal (Jury)


  • End-of-Life Care
  • chronic diseases
  • continuous care
  • death

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