Integrating palliative care into secondary public healthcare facilities in Kerala, India: policy adherence, sufficiency of services and quality of care

Purpose The study evaluates the integration of palliative services into secondary care facilities of the public health system and its impact on the sufficiency of palliative services and the quality of care received by beneficiaries. Design/methodology/approach The paper analyzes the structure and functioning of Kerala’s best-performing secondary pain and palliative care unit to understand its adherence to the Pain and Palliative Care Policy, GoK, 2019. Qualitative data were collected from selected stakeholders to understand the integration process and unearth the factors contributing to policy-practice integration. Quantitative data related to disease profile, sufficiency of palliative services and quality of care were collected from 38 beneficiaries attached to the unit. Findings Adherence to the stipulated policy guidelines enhances the quality of integrating palliative services into secondary care facilities of the public health system. This, in turn, improves the quality of care and sufficiency of services and reduces expenditure incurred for palliative care. Research limitations/implications A major limitation of the study is that the findings are based on the analysis of the best-performing palliative unit. More such studies are needed to generalize the findings. However, the domains that have been found significant in the process of integration can be replicated in extending palliative care services. Originality/value The quality of policy-practice integration is affected by the nature of guiding policy, synchronization with primary care facilities, planning and coordination and community support. Introducing specialty palliative care at secondary care facilities improves the quality and sufficiency of service and is cost-effective.