Health-care costs are growing, with little population-based data about people's priorities for end-of-life
care, to guide service development and aid discussions.
We examined variations in people's priorities for
treatment, care and information across seven European countries.
Telephone survey of a random sample
of households; we asked respondents their priorities if 'faced with a serious illness, like cancer, with limited time to live'
and used multivariable logistic regressions to identify associated factors.
the general public aged ≥ 16 years residing in England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain.
total, 9344 individuals were interviewed. Most people chose 'improve quality of life for the time they had left', ranging
from 57% (95% confidence interval: 55%-60%, Italy) to 81% (95% confidence interval: 79%-83%, Spain). Only 2% (95% confidence
interval: 1%-3%, England) to 6% (95% confidence interval: 4%-7%, Flanders) said extending life was most important, and 15%
(95% confidence interval: 13%-17%, Spain) to 40% (95% confidence interval: 37%-43%, Italy) said quality and extension were
equally important. Prioritising quality of life was associated with higher education in all countries (odds ratio = 1.3 (Flanders)
to 7.9 (Italy)), experience of caregiving or bereavement (England, Germany, Portugal), prioritising pain/symptom control over
having a positive attitude and preferring death in a hospice/palliative care unit. Those prioritising extending life had the
highest home death preference of all groups. Health status did not affect priorities.
countries, extending life was prioritised by a minority, regardless of health status. Treatment and care needs to be reoriented
with patient education and palliative care becoming mainstream for serious conditions such as cancer.