Policy priorities in palliative and end-of-life care: An exploration of issues reflected in public strategy.

OBJECTIVES

To map the issues and priorities reflected in palliative and end-of-life care policy in Australia.

METHODS

A qualitative documentary policy analysis examined the content of national and state-based policies and strategies on palliative and end-of-life care that were published in Australia and identified during July-September 2020. Summative content analysis was used to quantify policy characteristics, key domains and depth of coverage across strategy documents and to identify emergent themes.

RESULTS

Nine policies comprising a total of 304 pages published from 2005-2019 and covering all jurisdictions of Australia were included. Whilst there was breadth of coverage of key palliative care domains across policies, the depth to which they were covered varied. Use of research evidence to guide policy outcomes was infrequent. Aspirational narratives were commonly used to convey shared principles of person-centred, high quality, integrated, coordinated and accessible care for the person and their family carer. The conceptual framing and definitions of palliative care and end-of-life care were inconsistent and varied, and there was a disconnect between this framing and the target audiences, the actions to achieve priority areas, and the intended outcomes.

CONCLUSIONS

This study documented the key priorities articulated in palliative care and end-of-life care policy in Australia, revealing possibilities for a re-imagined best-practice evidence-to-policy cycle.