{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T01:07:47Z","timestamp":1775178467746,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T00:00:00Z","timestamp":1691625600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Dying and death are public health concerns, but little is known about public health interventions that target populations living with life-limiting illnesses. This gap makes it difficult to identify best-practice public health interventions for this population and to achieve public health objectives. The study aimed to describe a public health intervention that intends to improve population-level outcomes using point-of-care and patient-reported outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A case study approach, informed by the Organization for Economic Co-operation and Development's (OECD) Best-Practice Public Health Framework, was used to describe coverage, effectiveness, and equity using mixed methods. Data from 2012 to 2022 were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the 10-year period, the number of deaths recorded in the programme (<jats:italic>n<\/jats:italic> = 16,358 to 32,421, +98.2%) as well as the percentage of the population that might benefit from palliative care increased (14.8% to 25.1%). The median age of those admitted for care (74 to 77 years) and the proportion of services participating in the programme located in outer regional and remote areas of Australia increased (2012: 59; 2022: 94; +5.4%). The access by patients that experience the greatest socioeconomic disadvantage decreased (2012: 18.2% <jats:italic>n<\/jats:italic> = 4,918; 2022: 15.9% <jats:italic>n<\/jats:italic> = 9,525). Improvements in relation to moderate distress related to pain were identified (2012: 63% <jats:italic>n<\/jats:italic> = 8,751, 2022: 69% <jats:italic>n<\/jats:italic> = 13,700), and one in five instances of severe distress related to pain did not improve (2012: 20% <jats:italic>n<\/jats:italic> = 781; 2022: 19% <jats:italic>n<\/jats:italic> = 635).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Population-level, patient-reported outcome data are useful and necessary in addressing public health objectives in populations with life-limiting illnesses. Our application of the OECD's Best-Practice Public Health Framework has helped to identify and describe a national intervention that may be transferred to other settings to address health promotion objectives. This may help improve the targeting of treatments to improve pain and issues related to equity.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1232881","type":"journal-article","created":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T22:27:41Z","timestamp":1691706461000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Population-level, patient-reported outcomes: a case study regarding a public health intervention that involves patients with life-limiting illnesses"],"prefix":"10.3389","volume":"11","author":[{"given":"Barbara","family":"Daveson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabina","family":"Clapham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kylie","family":"Draper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alanna","family":"Connolly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Currow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,8,10]]},"reference":[{"key":"B1","first-page":"9","article-title":"Sixty-seventh World Health Assem","volume":"24","year":"2014"},{"key":"B2","volume-title":"Guidebook on Best Practices in Public Health","year":"2022"},{"key":"B3","doi-asserted-by":"publisher","first-page":"68","DOI":"10.3389\/fpubh.2018.00068","article-title":"Big data's role in precision public health","volume":"6","author":"Dolley","year":"2018","journal-title":"Front Public Health."},{"key":"B4","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.jpainsymman.2014.09.011","article-title":"The need for palliative care in Ireland: a population-based estimate of palliative care using routine mortality data, inclusive of nonmalignant conditions","volume":"49","author":"Kane","year":"2015","journal-title":"J Pain Symptom Manage"},{"key":"B5","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1200\/JCO.2014.57.3568","article-title":"Emergency department attendance by patients with cancer in their last month of life: a systematic review and meta-analysis","volume":"33","author":"Henson","year":"2015","journal-title":"J Clin Oncol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1111\/1753-6405.13197","article-title":"Variations in utilisation of colorectal cancer services in South Australia indicated by MBS\/PBS benefits: a benefit incidence analysis","volume":"46","author":"Lal","year":"2022","journal-title":"Aust N Z J Public Health."},{"key":"B7","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1177\/0269216316663855","article-title":"Caregiver characteristics and bereavement needs: findings from a population study","volume":"31","author":"DiGiacomo","year":"2017","journal-title":"Palliat Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1177\/0269216308098793","article-title":"Defining distinct caregiver subpopulations by intensity of end-of-life care provided","volume":"23","author":"Abernethy","year":"2009","journal-title":"Palliat Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1177\/0269216307085182","article-title":"Populations who die without specialist palliative care: does lower uptake equate with unmet need?","volume":"22","author":"Currow","year":"2008","journal-title":"Palliat Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1177\/02692163221077850","article-title":"Civic engagement in serious illness, death, and loss: a systematic mixed-methods review","volume":"36","author":"D'Eer","year":"2022","journal-title":"Palliat Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1186\/s12904-022-01021-3","article-title":"How compassionate communities are implemented and evaluated in practice: a scoping review","volume":"21","author":"Dumont","year":"2022","journal-title":"BMC Palliat Care."},{"key":"B12","doi-asserted-by":"publisher","first-page":"3853","DOI":"10.1200\/JCO.2008.16.5761","article-title":"Is it feasible and desirable to collect voluntarily quality and outcome data nationally in palliative oncology care?","volume":"26","author":"Currow","year":"2008","journal-title":"J Clin Oncol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"100019","DOI":"10.1016\/j.anzjph.2023.100019","article-title":"Considering community care in public health responses: A national study regarding palliative care during a prolonged coronavirus disease 2019 lockdown","volume":"47","author":"Daveson","year":"2023","journal-title":"Aust N Z J Public Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1177\/0269216313489367","article-title":"How many people need palliative care? A study developing and comparing methods for population-based estimates","volume":"28","author":"Murtagh","year":"2014","journal-title":"Palliative Medicine."},{"key":"B15","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1097\/SPC.0b013e328356aaed","article-title":"Identifying needs and improving palliative care of chronically ill patients: a community-oriented, population-based, public-health approach","volume":"6","author":"G\u00f3mez-Batiste","year":"2012","journal-title":"Curr Opin Support Palliat Care."},{"key":"B16","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1191\/0269216305pm1067oa","article-title":"Estimating the size of a potential palliative care population","volume":"19","author":"Rosenwax","year":"2005","journal-title":"Palliat Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"e0247250","DOI":"10.1371\/journal.pone.0247250","article-title":"The PCOC symptom assessment scale (SAS): a valid measure for daily use at point of care and in palliative care programs","volume":"16","author":"Daveson","year":"2021","journal-title":"PLoS ONE."},{"key":"B18","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1089\/jpm.2009.0318","article-title":"Caregivers of people with neurodegenerative diseases: profile and unmet needs from a population-based survey in South Australia","volume":"13","author":"Aoun","year":"2010","journal-title":"J Palliat Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1177\/082585979801400306","article-title":"Congruence between patients' and family caregivers' perceptions of symptom distress in patients with terminal cancer","volume":"14","author":"Kristjanson","year":"1998","journal-title":"J Palliat Care."},{"key":"B20","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/S0885-3924(97)00022-5","article-title":"Perceptions of symptom distress in lung cancer patients: I. Congruence between patients and primary family caregivers","volume":"14","author":"Lobchuk","year":"1997","journal-title":"J Pain Symptom Manage."},{"key":"B21","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1024\/1012-5302.12.6.352","volume":"12","author":"Lobchuk","year":"1999","journal-title":"Pflege."},{"key":"B22","unstructured":"Socio-Economic Indexes For Areas (SEIFA) 2016.2016"},{"key":"B23","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1093\/eurpub\/ckt029","article-title":"Learning from the public: citizens describe the need to improve end-of-life care access, provision and recognition across Europe","volume":"24","author":"Daveson","year":"2014","journal-title":"Eur J Public Health."},{"key":"B24","unstructured":"United Nations2023"},{"key":"B25","volume-title":"Deaths Web Report\u2014Supplementary Tables","author":"Welfare","year":"2022"},{"key":"B26","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.esmoop.2022.100483","article-title":"Assessment of the management of carcinomatous meningitis from breast cancer globally: a study by the breast international group brain metastasis task force","volume":"7","author":"Razis","year":"2022","journal-title":"ESMO Open"},{"key":"B27","doi-asserted-by":"publisher","first-page":"e227","DOI":"10.1016\/S2666-7568(22)00031-9","article-title":"A longevity society requires integrated palliative care models for historically excluded older people","volume":"3","author":"Rosa","year":"2022","journal-title":"The Lancet Healthy Longevity."},{"key":"B28","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1191\/0269216304pm873oa","article-title":"Specialist palliative care needs of whole populations: a feasibility study using a novel approach","volume":"18","author":"Currow","year":"2004","journal-title":"Palliat Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1186\/1472-6963-12-424","article-title":"Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage. A national study using spatial analysis","volume":"12","author":"Currow","year":"2012","journal-title":"BMC Health Serv Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.1136\/bmj.316.7140.1310","article-title":"Development and importance of health needs assessment","volume":"316","author":"Wright","year":"1998","journal-title":"Bmj."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1232881\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T22:27:47Z","timestamp":1691706467000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2023.1232881\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,10]]},"references-count":30,"alternative-id":["10.3389\/fpubh.2023.1232881"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2023.1232881","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,10]]},"article-number":"1232881"}}