Have a personal or library account? Click to login
Inequity in access to palliative care services worldwide and in Slovenia Cover

Inequity in access to palliative care services worldwide and in Slovenia

Open Access
|Feb 2026

References

  1. World Health Organisation. Palliative Care [Internet]. 2025 [cited 2025 Aug 20]. Available at: https://www.who.int/news-room/fact-sheets/detail/palliative-care
  2. El-Jawahri A, Greer JA, Pirl WF, Park ER, Jackson VA, Back AL, et al. Effects of early integrated palliative care on caregivers of patients with lung and gastrointestinal cancer: a randomized clinical trial. Oncologist 2017; 22: 1528-34. doi: 10.1634/theoncologist
  3. Brennan F. Palliative care as an international human right. J Pain Symptom Manage 2007; 33: 494-9. doi: 10.1016/j.jpainsymman
  4. Connor S. Global atlas of palliative care. 2nd edition [Internet]. 2020 [cited 2025 Aug 20]. Available at: https://www.thewhpca.org
  5. Garralda E, Tripodoro VA, Ling J, Brennan J, Montero Á, Bastos F, et al. EAPC atlas of palliative care in the European region 2025 [Internet]. 2025 [cited 2025 Aug 20]. Available at: https://dadun.unav.edu/entities/publication/b7868dba-dcdb-40a8-bf30-72c1635b6e18
  6. Lutz S. The history of hospice and palliative care. Curr Probl Cancer 2011; 35: 304-9. doi: 10.1016/j.currproblcancer
  7. Milicevic N. The hospice movement: history and current worldwide situation. Arch Oncol 2002; 10: 29-31. doi: 10.2298/AOO0201029M
  8. Stevens EM, Jackson S, Milligan S. Palliative nursing: across the spectrum of care. Iowa (USA): Wiley-Blackwell; 2009.
  9. Kearney M. Palliative medicine – just another specialty? Palliat Med 1992; 6: 39-46.
  10. Soundings. BMJ 1992; 304: 579. doi: 10.1136/bmj.304.6826.579
  11. Randall F, Downie RS. The philosophy of palliative care: critique and reconstruction. Oxford: Oxford University Press; 2006.
  12. Floriani CA, Schramm FR. Routinization and medicalization of palliative care: losses, gains and challenges. Palliat Support Care 2012; 10: 295-303. doi: 10.1017/S1478951511001039
  13. Clark D. From margins to centre: a review of the history of palliative care in cancer. Lancet Oncol 2007; 8: 430-8. doi: 10.1016/S1470-2045(07)70138-9
  14. Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: the World Health Organization’s global perspective. J Pain Symptom Manage 2002; 24: 91-6. doi: 10.1016/s0885-3924(02)00440-2.
  15. Seymour J. Looking back, looking forward: the evolution of palliative and end-of-life care in England. Mortality 2012; 17: 1-17. doi: 10.1080/13576275.2012.651843
  16. World Health Organisation. Cancer Control: Knowledge into Action: WHO Guide for Effective Programmes: Module 5: Palliative Care [Internet]. 2007 [cited 2025 Aug 20]. Available at: https://www.who.int/news-room/fact-sheets/detail/palliative-care
  17. Turner M, Peacock M. Palliative care in UK prisons. J Correct Health Care 2017; 23: 56-65. doi: 10.1177/1078345816684847
  18. Abu-Odah H, Molassiotis A, Liu J. Challenges on the provision of palliative care for patients with cancer in low-and middle-income countries: a systematic review of reviews. BMC Palliat Care 2020; 19: 55. doi: 10.1186/s12904-020-00558-5
  19. Harding R, Epiphaniou E, Chidgey-Clark J. Needs, experiences, and preferences of sexual minorities for end-of-life care and palliative care: a systematic review. J Palliat Med 2012; 15: 602-11. doi: 10.1089/jpm.2011.0279
  20. Read S. Learning disabilities and palliative care: recognizing pitfalls and exploring potential. Int J Palliat Nurs 2005; 11: 15-20. doi: 10.12968/ijpn.2005.11.1.17446
  21. Tuffrey-Wijne I. The palliative care needs of people with intellectual disabilities: a literature review. Palliat Med 2003; 17: 55-62. doi: 10.1191/0269216303pm668oa
  22. Ebert Moltara M, Boltežar L, Ivanetič Pantar M, Bernot M. Palliative care – the needs of patients with incurable illnesses and their relatives. In: Ramšak M, editor. Social diversity and access to healthcare. 1st edition. Baden-Baden: Verlag Karl Alber; p. 196-209.
  23. Chen ML. Inequity of palliative care for non-cancer patients. J Nurs Res 2019; 27: 1-2. doi: 10.1097/JNR.0000000000000324
  24. United Nations Office on Drugs and Crime. Ensuring adequate access for medical and scientific purposes [Internet]. 2025 [cited 2025 Aug 20]. Available at: https://www.unodc.org/documents/drug-prevention-and-treatment/INCB_Access_Supplement-AR15_availability_English.pdf
  25. Bruera E, Sweeney C. Palliative care models: international perspective. J Palliat Med 2002; 5: 319-27. doi: 10.1089/109662102753641331
  26. Hawley P. Barriers to access to palliative care. Palliat Care 2017; 10: 1178224216688887. doi: 10.1177/1178224216688887
  27. Trivedi N, Peterson EB, Ellis EM, Ferrer RA, Kent EE, Chou WYS. Awareness of palliative care among a nationally representative sample of U.S. adults. J Palliat Med 2019; 22: 1578-82. doi: 10.1089/jpm.2018.0656
  28. Shen JJ, Dingley C, Yoo JW, Rathi S, Kim SK, Kang HT, et al. Sociocultural factors associated with awareness of palliative care and advanced care planning among Asian populations. Ethn Dis 2020; 30: 459-68. doi: 10.18865/ed.30.3.459
  29. Bazargan M, Cobb S, Assari S, Kibe LW. Awareness of palliative care, hospice care, and advance directives in a racially and ethnically diverse sample of California adults. Am J Hosp Palliat Care 2021; 38: 601-9. doi: 10.1177/1049909121991522
  30. Atena D, Imane B, Maryam R, Naiire S, Fatemeh T. The level of knowledge about palliative care in Iranian patients with cancer. BMC Palliat Care 2022; 21: 33. doi: 10.1186/s12904-022-00920-9
  31. Kemp C. Cultural issues in palliative care. Semin Oncol Nurs 2005; 21: 44-52. doi: 10.1053/j.soncn.2004.10.007
  32. Gatrad R, Sheikh A. Palliative care for Muslims and issues after death. Int J Palliat Nurs 2002; 8: 594-7. doi: 10.12968/ijpn.2002.8.12.10977
  33. Sarhill N, LeGrand S, Islambouli R, Davis MP, Walsh D. The terminally ill Muslim: death and dying at the Muslim perspective. Am J Hosp Palliat Care 2001; 18: 251-5. doi: 10.1177/104990910101800409
  34. Sachedina A. End-of-life: the Islamic view. Lancet 2005; 366: 774-9. doi: 10.1016/S0140-6736(05)67183-8
  35. Sallnow L, Kumar S, Numpeli M. Home-based palliative care in Kerala, India: the neighbourhood network in palliative care. Prog Palliat Care 2010; 18: 14-7. doi: 10.1179/096992610X12624290276142
  36. Zeinah GF, Al-Kindi SG, Hassan AA. Middle East experience in palliative care. Am J Hosp Palliat Care 2013; 30: 94-9. doi: 10.1177/1049909112439619
  37. Hannon B, Zimmermann C, Knaul FM, Powell RA, Mwangi-Powell FN, Rodin G. Provision of palliative care in low-and middle-income countries: overcoming obstacles for effective treatment delivery. J Clin Oncol 2016; 34: 62-8. doi: 10.1200/JCO.2015.62.1615
  38. Evans N, Meñaca A, Koffman J, Harding R, Higginson IJ, Pool R, et al. Cultural competence in end-of-life care: terms, definitions, and conceptual models at the British literature. J Palliat Med 2012; 15: 812-20. doi: 10.1089/jpm.2011.0526
  39. Bazargan M, Bazargan-Hejazi S. Disparities in palliative and hospice care and completion of advance care planning and directives among Non-Hispanic blacks: a scoping review of recent literature. Am J Hosp Palliat Care 2021; 38: 688-718. doi: 10.1177/1049909120966585
  40. Islam JY, Deveaux A, Previs RA, Akinyemiju T. Racial and ethnic disparities in palliative care utilization among gynecological cancer patients. Gynecol Oncol 2021; 160: 469-76. doi: 10.1016/j.ygyno.2020.11.031
  41. Wentlandt K, Krzyzanowska MK, Swami N, Rodin GM, Le LW, Zimmermann C. Referral practices of oncologists to specialized palliative care. J Clin Oncol 2012; 30: 4380-6. doi: 10.1200/JCO.2012.44.0248
  42. Kumar SK. Kerala, India: a regional community-based palliative care model. J Pain Symptom Manage 2007; 33: 623-7. doi: 10.1016/j.jpainsymman.2007.02.005
  43. Hearn J, Higginson IJ. Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review. Palliat Med 1998; 12: 317-32. doi: 10.1191/026921698676226729
  44. Golob N, Oblak T, Čavka L, Kušar M, Šeruga B. Aggressive anticancer treatment in the last 2 weeks of life. ESMO Open 2024; 9: 102937. doi: 10.1016/j. esmoop.2024.102937
  45. Bassah N, Vaughn L, Santos Salas A. Nurse-led adult palliative care models in low- and middle-income countries: A scoping review. J Adv Nurs 2023; 79: 4112-26. doi: 10.1111/jan.15646
  46. Lynch T, Connor S, Clark D. Mapping levels of palliative care development: a global update. J Pain Symptom Manage 2013; 45: 1094-106. doi: 10.1016/j. jpainsymman.2012.05.011
  47. Wright M, Wood J, Lynch T, Clark D. Mapping levels of palliative care development: a global view. J Pain Symptom Manage 2008; 35: 469-85. doi: 10.1016/j.jpainsymman.2007.06.006
  48. Narcotics Control Board I. Report of the International Narcotics Control Board for 2023 [Internet]. 2023 [cited 2025 Aug 20]. Available at: www. incb.org
  49. Robertson E, Bambala A, Kalungia AC, Marshall S, Mbozi P, Munkombwe D. Prescribers’ experiences of, and attitudes to, use of morphine for palliative care at a tertiary hospital in Zambia. Hosp Pract 2020; 48: 86-91. doi: 10.1080/21548331.2020.1733318
  50. Soto-Perez-de-Celis E, Chavarri-Guerra Y, Pastrana T, Ruiz-Mendoza R, Bukowski A, Goss PE. End-of-life care in Latin America. J Glob Oncol 2016; 3: 261-70. doi: 10.1200/JGO.2016.005579
  51. Are M, McIntyre A, Reddy S. Global disparities in cancer pain management and palliative care. J Surg Oncol 2017; 115: 637-41. doi: 10.1002/jso.24585
  52. Herce ME, Elmore SN, Kalanga N, Keck JW, Wroe EB, Phiri A, et al. Assessing and responding to palliative care needs in rural sub-Saharan Africa: results at a model intervention and situation analysis in Malawi. PLoS One 2014; 9: e110457. doi: 10.1371/journal.pone.0110457
  53. Rajagopal MR, Karim S, Booth CM. Oral morphine use in South India: a population-based study. J Glob Oncol 2017; 3: 720-7. doi: 10.1200/JGO.2016.007872
  54. Vijay D, Koksvik GH. Waiting for care and community organizing for serious health-related suffering in Kerala, India. Med Anthropol 2024; 43: 338-52. doi: 10.1080/01459740.2024.2351066
  55. Ghosh A, Dzeng E, Cheng MJ. Interaction of palliative care and primary care. Clin geriatr Med 2015; 31: 207-18. doi: 10.1016/j.cger.2015.01.001
  56. Moltara ME. Perspective chapter: the development and integration of palliative care at the Institute of Oncology Ljubljana. In: Bollig G, Zelko E, editors. Palliative care [Internet]. Rijeka: IntechOpen; 2023. doi: 10.5772/intechopen.1003064
  57. Zupančič Slavec Z. [Development of palliative care]. [Slovenian]. In: Jaunig S, editor. [History of healthcare and medicine in Slovenia: internal medicine, emergency and urgent medical care, palliative care]. [Slovenian]. Celje: Celjska Mohorjeva Družba; 2024.
  58. Golob N. [Aggressiveness of cancer treatment and other medical care in patients with metastatic solid cancer near the end of life]. [Dissertation]. Ljubljana (SLO): University of Ljubljana; 2024.
  59. GOV.SI: Ministry of Health of the Republic of Slovenia. [Palliativna care]. [Slovenian]. [Internet]. 2025 [cited 2025 Aug 20]. Available at: https://www. gov.si/teme/paliativna-oskrba/
  60. GOV.SI: Ministry of Health of the Republic of Slovenia. [Strengthening palliative mobile teams]. [Slovenian]. [Internet]. 2025 [cited 2025 Aug 20]. Available at: https://www.gov.si/zbirke/projekti-in-programi/krepitev-paliativnih-mobilnih-timov/
  61. Benedik J, Berlec K, Bernot M, Crljenica S, Ebert Moltara M, Globočnik Kukovica M, et al. [Palliative care of adult cancer patients in Slovenia – basic concepts and recommendations]. [Slovenian]. 1st Edition. Ebert Moltara M, Bernot M, editors. Ljubljana: Institute of Oncology Ljubljana; 2023.
  62. Medical Chamber of Slovenia. The state of palliative care in Slovenia [Slovenian]. [Internet]. 2018 [cited 2025 Aug 20]. Available at: https://www.zdravniskazbornica.si/docs/default-source/isis/golob-nena_stanje-paliativne-oskrbe-v-sloveniji_splet_isis-7-2019.pdf?sfvrsn=63f33136_2
  63. Ebert Moltara M, Bernot M, Benedik J, Žist A, Golob N, Malačič S, et al. [Basic concepts and proposed terminology in palliative care]. [Slovenian]. Ebert Moltara M, editor. Ljubljana: Slovenian Association of Palliative and Hospice Care; 2022.
  64. Ebert Moltara M, Koritnik B, Meglič A, Kolšek-Šušteršič M, Rožman S, Bernot M, et al. [Palliative care referral]. 1st Edition. Ebert Moltara M, Malačič S, Gumilar I, editors. Ljubljana: Slovenian Association of Palliative and Hospice Care; 2021.
  65. Hui D, Meng YC, Bruera S, Geng Y, Hutchins R, Mori M, et al. Referral criteria for outpatient palliative cancer care: a systematic review. Oncologist 2016; 21: 895-901. doi: 10.1634/theoncologist.2016-0006
  66. Hui D, Mori M, Watanabe SM, Caraceni A, Strasser F, Saarto T, et al. Referral criteria for outpatient specialty palliative cancer care: an international consensus. Lancet Oncol 2016; 17: e552-9. doi: 10.1016/S1470-2045(16)30577-0
  67. EAPC2023 abstract book. Palliat Med 2023; 37(1 Suppl): 1-302. doi: 10.1177/02692163231172891
  68. Charalambous H, Pallis A, Hasan B, O’Brien M. Attitudes and referral patterns of lung cancer specialists in Europe to specialized palliative care (SPC) and the practice of early palliative care (EPC). BMC Palliat Care 2014; 13: 59. doi: 10.1186/1472-684X-13-59
  69. Čebron Lipovec N. Opioid analgesics prescribing trends 2010–2019 in Slovenia: National database study. Hum Psychopharmacol 2024; 39: e2891. doi: 10.1002/hup
DOI: https://doi.org/10.2478/raon-2026-0009 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Submitted on: Oct 9, 2025
|
Accepted on: Dec 29, 2025
|
Published on: Feb 4, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Nena Golob, Maja Ebert Moltara, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

AHEAD OF PRINT