全球死亡質(zhì)量排名：英國居首位

全球死亡質(zhì)量排名：英國居首位

Quality of death around the world

Britain may not be the best place to live, but it is the best place to die.

英國可能不是最適宜居住的地方，但卻是最適合死的地方。

The Economist Intelligence Unit (EIU) ranked the country first in its latest quality-of-death index, which uses 20 quantitative and qualitative indicators to measure the effectiveness of end-of-life care in 80 countries. The measures include the the quality of palliative care, affordability, the health care environment, and community engagement.

《經(jīng)濟(jì)學(xué)人》信息部(EIU)在其最新的“死亡質(zhì)量指數(shù)”排名上將英國排在第一位，這一指數(shù)運(yùn)用20個(gè)定量和定性指標(biāo)，對80個(gè)國家的臨終關(guān)懷效率進(jìn)行分析。這些指標(biāo)包括臨終關(guān)懷質(zhì)量、經(jīng)濟(jì)負(fù)擔(dān)能力、醫(yī)療環(huán)境和社會(huì)參與度。

How we die is becoming a critical topic as populations live longer, often with multiple diseases requiring complex (and costly) management. Developing countries in particular grapple with how to deliver basic pain relief to the dying. Some have seen notable improvements in recent years: Uganda has dramatically increased the availability of morphine through a public-private partnership between the health ministry and Hospice Africa, a British charity.

隨著人類壽命的延長，各種疾病要求很復(fù)雜(且昂貴)的護(hù)理，如何度過生命的最后時(shí)光正逐漸成為一個(gè)重要問題。發(fā)展中國家更是苦于如何為病危的人提供緩解痛苦的服務(wù)。有些國家近幾年取得了一些顯著的進(jìn)步：在烏干達(dá)，當(dāng)?shù)匦l(wèi)生部與英國慈善機(jī)構(gòu)非洲臨終關(guān)懷中心(Hospice Africa)建立了公私合作關(guān)系，極大地推廣了嗎啡在非洲的使用。

Not surprisingly, rich countries generally did better than poor ones in the rankings. But there are noteworthy variations: the US came in ninth place with a score of 80.8 (out of 100), far below the 93.9 score achieved by Britain, where complaining about health care is as popular as grumbling about the weather.

不出所料，富裕的國家通常都比貧窮的國家排名靠前，但也有些值得注意的變化：美國以80.8分(100分制)排名第九，遠(yuǎn)低于英國的93.9分，主要原因是美國的醫(yī)療衛(wèi)生系統(tǒng)飽受詬病。

Quality-of-Death Index in High-Income Countries and Regions 高收入國家和地區(qū)死亡質(zhì)量指數(shù)

Score is out of 100. (Economist Intelligence Unit / Quartz)

滿分為100分

Costa Rica ranks top among middle-income countries, thanks in part to extensive volunteer networks that support public services, according to the EIU.

哥斯達(dá)黎加(Costa Rica)在中等收入國家中排名第一，據(jù)EIU分析，這一結(jié)果部分得益于該國廣泛的志愿者系統(tǒng)為公共服務(wù)提供了很多支持。

Quality-of-Death Index in Middle-Income Countries 中等收入國家死亡質(zhì)量指數(shù)

Score is out of 100. (Economist Intelligence Unit / Quartz)

The most striking finding in the report is that Mongolia, a poor country with few provisions for end-of-life care in 2000, now leads the low-income countries with a score of 57.7, which puts it 28th overall, above a host of more advanced economies. It “overachieves by some margin given its resources,” according to the EIU.

報(bào)告中最令人驚訝的是蒙古，它在2000年時(shí)還是一個(gè)對臨終關(guān)懷投入很少的貧窮國家，現(xiàn)在卻得分57.7，在低收入國家中位居第一，總排名28，超過了許多更先進(jìn)的國家。EIU的報(bào)告稱，“鑒于蒙古的資源狀況，該國真是超額完成了任務(wù)。”

Quality-of-Death Index in Low-Income Countries 低收入國家死亡質(zhì)量指數(shù)

Score is out of 100. (Economist Intelligence Unit / Quartz)

Remarkably, Mongolia’s performance is largely attributed to the work of a single doctor, Odontuya Davaasuren, a pediatrician who learned about the latest advancements in end-of-life care at a conference in Sweden and brought some of the ideas back to her home country. When Davaasuren set up the Mongolian Palliative Care Society (MPCS) in 2000, the country had no hospices or palliative care teaching programs. “We did not even have the terminology for palliative care,” she says.

值得一提的是，蒙古取得如此驕人的成績，很大程度上要?dú)w功于一位醫(yī)生的努力。她叫Odontuya Davaasuren，是一名兒科醫(yī)生，她在瑞典的一次醫(yī)學(xué)會(huì)議上了解到了臨終關(guān)懷的最新進(jìn)展，并把一些觀念帶回了祖國。2000年，Davaasuren醫(yī)生創(chuàng)立了蒙古臨終關(guān)懷中心(Mongolian Palliative Care Society，MPCS)，當(dāng)時(shí)整個(gè)國家都沒有臨終關(guān)懷的教育體系。“我們當(dāng)時(shí)甚至都沒有臨終關(guān)懷的專業(yè)術(shù)語，”Davaasuren醫(yī)生說道。

According to the EIU, her work helped establish 10 palliative-care facilities in Ulaanbaatar, with provincial hospitals also now able to accommodate patients in need of such care. Palliative care is now included in health and welfare legislation, and taught at medical schools. Affordable morphine is now available and prescribed more widely. The country is also now expanding non-cancer and pediatric palliative-care services, in addition to “outpatient consultation and nursing, home care, and spiritual and social services,” Davaasuren says.

EIU的報(bào)告稱，在Davaasuren醫(yī)生的努力下，烏蘭巴托成立了10家臨終關(guān)懷中心，各省級醫(yī)院也能夠?yàn)椴∪颂峁┐祟惙?wù)。臨終關(guān)懷現(xiàn)已被納入健康和福利立法當(dāng)中，各醫(yī)學(xué)院校也開設(shè)了相關(guān)課程。價(jià)格親民的麻醉劑應(yīng)用越來越廣泛，規(guī)定也更加寬泛。蒙古還推行非癌癥和兒童療養(yǎng)服務(wù)，除此之外，“門診會(huì)診、普通護(hù)理、家庭護(hù)理、精神和社會(huì)服務(wù)也在進(jìn)行。”Davaasuren醫(yī)生說道。

In spite of recent progress around the world, the EIU notes that experts estimate that globally less than 10 percent of people who require end-of-life care actually receive it.

盡管近年來全球在臨終關(guān)懷方面取得了進(jìn)步，但是EIU指出，專家估計(jì)，全球只有不到10%的人真正得到了所需的臨終關(guān)懷。