Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021

The Lien Centre for Palliative Care at Duke-NUS Medical School, commissioned by the Lien Foundation, has produced the Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021. This effort systematically ranks and grades 79 countries (and Hong Kong and Taiwan), representing 81% of the world’s population, on the quality of end-of-life (EOL) care based on input from experts within each of the included countries. Rankings and grades are based on 13 key indicators developed through a literature review and cognitive interviews and after applying importance weights that measure the relative importance of each level of each indicator based on survey responses from key stakeholders.

Ranking of top 10 Countries

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The lists displays the top 10 countries by Rank and Score.

Results highlight the large disparities in the quality of EOL care across countries, and especially between the highest income countries and others. There are various enabling factors observed in many of the high-income countries which can provide a starting point to improve the EOL experience for patients and families worldwide. These include greater integration of palliative care into the community and within the broader health system and reducing the financial burden of EOL care to patients and their families, among others.