Needs-based end-of-life care is a quality management approach that evaluates the individual needs of the patients and their families and carers, and coordinates appropriate care.
The end-of-life needs of many patients are appropriately met by primary care providers (generalist, and other specialist and support care) with specialist palliative care providers contributing direct care, indirect care, or consultation advice as required.
This approach recognizes that patients with more complex needs may require periodic or ongoing direct care from specialist palliative care providers.
It is proposed that all people with a life-limiting illness (including their carers, family, and community) be conceptualized as falling within three broad subgroups, based on the complexity of their needs.
, the largest sub-group, is those patients who do not require access to specialist care to meet their needs, which are met either through their own resources or with the support of primary care providers
is those patients who may have a temporary increase in their level of need and may require access to specialist palliative care services for consultation and advice.
They will continue to receive care from their primary care provider.
, likely to be the smallest subgroup, is those patients who have the greatest needs — those with complex physical, social, psychological, and/or spiritual needs that do not respond to simple or established protocols of care, and who usually require highly individualized care plans developed, implemented, and evaluated by knowledgeable and skilled specialist practitioners, in partnership with primary care providers
A Guide to Palliative Care Service Development: A population based approach
See figure 1: Conceptual model of level of need within the population of patients with a life limiting illness.
Palliative Care Australia. A Guide to Palliative Care Service Development: a population based approach. Internet. Accessed on July 5, 2016.