Taiwan ranked first in Asia for quality of palliative care

TAIPEI, Taiwan - Taiwan ranked first in Asia and sixth overall in an index measuring the quality of palliative care in 80 countries, according to a report released yesterday by The Economist Intelligence Unit (EIU). The island improved massively from its 14th place ranking in 2010. The rankings are released once every five years.

Rounding out the top five spots were the United Kingdom, Australia and New Zealand, along with Ireland and Belgium (tied for fourth place). Singapore, while placing second in Asia, was ranked 12th globally, Japan placed 14th, South Korea 18th, while mainland China placed 67th. There, according to the report, "the impact of the one-child policy, often leaving individuals caring for two parents and four grandparents, will lead to even more demand for outside resources to provide support."

According to the report, the island is one of the first countries worldwide to provide a palliative care framework with a Natural Death Act passed in 2000, along with extensive research programs, available training and accreditation in the field of palliative care, as well as high-quality services offered free of charge.

According to Fang Chun-kai, a specialist and instructor in palliative care at Mackay Memorial Hospital (Taipei), Taiwan's improved rankings were due to the fact that psychologists had entered into palliative care, taking over a role once dominated by social workers and religious figures. Psychologists, according to Fang, are not confined by religious denomination, while social workers are best suited to provide family services.

Fang added that Taiwan's health care environment has also improved (ranking fifth overall worldwide in the category). Other factors include combining palliative care with other units within hospitals. He added that Taiwan could stand to improve even more if it could increase diagnostic awareness to aid in determining which patients would benefit from palliative care, as well as increasing infrastructure to more remote regions of the island.

The Quality of Death Index is commissioned by a philanthropic organisation based in Singapore called the Lien Foundation, combining qualitative and quantitative indicators across five categories (palliative and health care environment; human resources; affordability of care; quality of care; community engagement) and includes interviews with more than 120 experts worldwide.

The report added that many developing countries will require resources to meet rising future need as the frequency of non-communicable diseases proliferates and as populations age more rapidly.