Palliative care in Europe: an emerging approach to comparative analysis.

At the national level, hospice and palliative care activities have been developing in Europe since the late 1960s. International organisations to support palliative care have been in existence since the late 1980s. It was only in the late 1990s, however, that the first comparative studies of European palliative care development were conducted. This article reviews this history and highlights the main studies and initiatives that have focused on the growth of palliative care in Europe. Evidence to date shows huge variations in the levels of palliative care provision that exist in different countries, as well as some differences in the preferred models of care. The extent to which palliative care provision is integrated with wider health and social care policies appears to be a crucial determinant of success. A sustainable evidence base on palliative care provision in Europe is needed, and there are encouraging signs that this is beginning to develop through close cooperation between key organisations and initiatives in the field.