Accessibility to palliative care services in Colombia: an analysis of geographic disparities.
Miguel Antonio S��nchez-C��rdenas, Marta Ximena Le��n, Luisa Fernanda Rodr��guez-Campos, Lina Mar��a Vargas-Escobar, Laura Cabezas, Juan Pablo Tamayo-D��az, Angela Ca��on Pi��eros, Nidia Mantilla-Manosalva, Genny Paola Fuentes-Bermudez
Author Information
Miguel Antonio S��nchez-C��rdenas: Universidad El Bosque, Bogot��, DC, Colombia. sanchezcmiguel@unbosque.edu.co. ORCID
Marta Ximena Le��n: School of Medicine, Universidad de La Sabana, Ch��a, Colombia.
Luisa Fernanda Rodr��guez-Campos: School of Medicine, Universidad de La Sabana, Ch��a, Colombia.
Lina Mar��a Vargas-Escobar: Universidad El Bosque, Bogot��, DC, Colombia.
Laura Cabezas: Universidad El Bosque, Bogot��, DC, Colombia.
Juan Pablo Tamayo-D��az: School of Medicine, Universidad de La Sabana, Ch��a, Colombia.
Angela Ca��on Pi��eros: Universidad El Bosque, Bogot��, DC, Colombia.
Nidia Mantilla-Manosalva: School of Medicine, Universidad de La Sabana, Ch��a, Colombia.
Genny Paola Fuentes-Bermudez: Department of Collective Health, Universidad Nacional de Colombia, Bogota, Colombia.
OBJECTIVES: Due to the increase in the prevalence of non-communicable diseases and the Colombian demographic transition, the necessity of palliative care has arisen. This study used accessibility and coverage indicators to measure the geographic barriers to palliative care. METHODS: Population-based observational study focused on urban areas and adult population from Colombia, which uses three measurements of geographic accessibility to services: a) density of palliative care services per 100,000 inhabitants, b) analysis of geographic distribution by territorial nodes of the country, and c) spatial analysis of palliative care services using Voronoi diagrams. ArcGIS Pro software was used to map services' locations and identify geographic disparities. RESULTS: A total of 504 palliative care services were identified, of which 77% were primary health care services. The density of palliative care services in Colombia is 1.8 primary care services per 100,000 inhabitants and 0.4 specialized services per 100,000 inhabitants. The average palliative care coverage is 41%, two regions of the country have a coverage below 30%. Twenty-eight percent of the services provide care for a population greater than 50,000 inhabitants within their coverage area, exceeding the acceptable limit by international standards. CONCLUSIONS: Palliative care services are concentrated in three main regions (Bogot�� D.C., the Center, and the Caribbean) and are limited in the Orinoquia and Amazonia nodes. Density of specialized palliative care services is extremely low and there are regions without palliative services for adults with palliative needs.
