Optimizing Care Transitions - A Systematic Review: The Need for Horizontal Transfer from Intensive Care Unit to Hospice in the Maldives

The Maldives has been known for its white beaches and crystal clear waters. Underneath the “sunny side of life,” the locals face critical challenges in all aspects of life. Even though there has been talk for a while among key stakeholders in the Maldives, these plans lack fruition. The concentration of intensive care unit (ICU) resources in the Greater Malé Region exacerbates economic disparities, leaving rural populations in the peripheral islands and other atolls underserved. This imposes logistical and financial burdens on the families taking care of these chronically ill patients. Prolonged ICU admissions by terminally ill patients lead to bed shortages (due to decreased bed turnover rate), inefficient use of hospital resources, and increased healthcare costs. The lack of palliative care options deprives patients of dignified, holistic care and places additional stress on patients and their families. Addressing barriers such as opioid access and workforce training is essential for delivering compassionate care. Systemic reforms in the Maldives are critical to ensuring equitable, efficient, and dignified end-of-life care aligned with universal healthcare goals as well as the goals of every individual.