World Health Organization 20, Avenue Appia

50
Ongoing data collection on palliative care integration, accessibility, quality and 
outcomes
The degree of integration of palliative care into a health care system, and its accessibility, may be assessed 
with a few output measures such as those developed by WHO for its periodic survey of NCD country 
capacity around the world 
(116). Such a study might explore:
n
whether government funding is provided for palliative care within primary care;
n
whether there is a national policy that includes palliative care and whether a national policy on 
primary care includes palliative care;
n
whether such policies are operational, under development, or not in effect;
n
whether oral morphine is available in over 50% of the primary care facilities of the public health 
sector;
n
whether palliative care is accessible by over 50% of patients in PHC in the public health system; and
n
whether palliative home care is accessible by over 50% of patients in PHC in the public health system.
To assess periodically the quality and outcomes of palliative care, the same instruments used for palliative 
care situation analyses can often be used. Where feasible, however, WHO endorses health technology 
assessment (HTA) to systematically evaluate the properties, effects and/or impacts of health interventions 
(Figure 1) 
(117). HTA covers both the direct, intended consequences of interventions and their indirect, 
unintended consequences. The approach is used to inform policy and decision-making in health care, 
especially on how best to allocate limited funds to health interventions. The assessment is conducted by 
interdisciplinary groups using explicit analytical frameworks, drawing on clinical, epidemiological, health 
economic and other information and methodologies. It may be applied to interventions, such as home care 
in public health insurance coverage, rolling out broad public health programmes such as palliative care, 
priority setting in health care, identifying health interventions that produce the greatest health gain and 
offer value for money, and formulating clinical guidelines.