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Mini Review Open Access
Background: There is global evidence of increased need for palliative care; however it has been relatively neglected in health policy and research. In absence of such data on Sint Maarten, this current study aimed to assess the palliative care needs based on a broader construct of palliation beyond terminal-care relying on evaluation of health services use.
Methodology: The study assesses the palliative care need, for both alive and dead patients, utilizing health care services on the Island country of St Maarten for the period September 2014 until June 2015. The palliative care criteria were developed with inputs from the Radbound criteria and the criteria developed by the centre to advance palliative care (CAPC). A questionnaire was designed and data was collected by emailing the questionnaire coupled with personal interviews with stakeholders (primary care physicians and specialists). Data was cross-validated with the data obtained from other healthcare facilities on the Island to prevent duplication.
Results: Data included responses from 12 General practices and specialists which included internists/oncologist and psychiatrists. To minimize the duplication and over-reporting of data by the specialists, conservative estimates of responses was chosen and arbitrarily 5% of the responses were considered. The physicians/specialists were also requested to provide estimated subjects per practice and based on the estimate a conservative sample size of 30,375 subjects was obtained. A total of 160 subjects (39 dead and 121 alive) qualified the broad palliative care criteria during the study period yielding an estimated point prevalence of 0.5 %.
Conclusions: Our study emphasizes a substantial need for palliative care services on Sint Maarten. The data reported is comparable globally. The comparative data from literature review suggests a facility with a maximum of 5 beds, though this capacity may be reduced if the service delivery model is considered to be a combination
Palliative care, Dutch Caribbean, Adolescent behaviour, Cognitive Mental Illness