Pediatric Palliative Care in Chile

Abstract

In Chile, the infant mortality rate is 7.8 per 1,000 live births and each year around 800 children aged 1–15 years die from various reasons such as trauma, violence, cancer and other life-limiting illnesses. Currently, palliative care (PC) is organized in pediatric hospitals, specifically in oncology units. However, it has been increasingly recognized that there is a need to develop PC units to provide care to children with other conditions. Cancer is the second leading cause of death in children between 5 and 15 years in Chile. It is estimated that there are 520 new cases of child cancer annually and of these, 85% are treated in the public health system. In 1988 the Children’s Cancer Program (PINDA) was started, dependent on the Ministry of Health, which works in a cross country network. The strategies for diagnosis, treatment and appropriate follow-up of children in the program have yielded an overall survival of 70%; however, despite this 30% of children die from disease progression. Since 2003, this group has access to a multi-care PC model which is given as a continuum of care throughout the progression of the disease, without referring patients to another team that does not know the patient or his/her family. The current challenge is to develop this type of care in other clinical situations, based on the experience gained in pediatric oncology, using the platform that delivers the public health system to ensure quality of service and fairness.