Surgical Care Services in inaccessible zones: Targeted Palliative Care Accessibility Models for patients in resource-limited settings.

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has caused a paradigm shift in the cancer care landscape, shifting from a palliative care approach to a need-based approach. In these current and upcoming future times, patient- and community-centred research becomes the cornerstone of collaborative assessment efforts for understanding and assessing Targeted Palliative Care (TPC) Accessibility Models for patients with oncological malignancies in resource-limited settings. This short communication focuses on the models available for TPC for the continuation of care in oncological settings in resource-limited geographic areas. Some programmes have used a Mixed Method Approach, highlighting their importance based on engagement volunteers and building trust and relationships in the community. Other studies have addressed the care system using a Rural Palliative Supportive Service Model for older adults living with life-limiting chronic illness, showing that home-based treatment for this population is feasible. Moreover, the Home Palliative Care Units (HPCU) model showed promising results in that patients cared for by HPCU had a fewer emergency visits and hospital admissions, in addition to being more likely to die at home with adequate palliation. During the ongoing pandemic, patients have experienced rapid clinical decline, requiring urgent conversations about their care wishes. They have been forced to make decisions on so-called 'Life and death' issues. In this article we discuss the advantages, disadvantages, and possible changes implemented in the context of cancer surgical care in resource-limited settings, in order to create a better assessment of geographic or demographic-based, patient- and community-centred TPC accessibility models for a more holistic development of cancer care programs.