All We Need is a Hospice in Brazil.

1. Utilizing an observational, cross-sectional, and multicenter approach, participants will self-report the ability to evaluate major differences in south America public and private hospital service, as an opportunity for improvement and considerations for future practices applications. 2. Utilizing quality control, data visualization and comparation, participants will self-report the ability to identify key elements in the emergency service to support the decision-making of implement palliative care. In our observational, cross-sectional, multicenter study, four emergency services in the city of Campinas, SP, Brazil participated. A total of 293 interviews were conducted with one third of the patients eligible for palliative care (PC). Thus, there is an extreme need for PC services and hospice in Brazil. Currently, it is estimated that only 14% of patients who need palliative care (PC) receive it1,2. In Brazil, this movement is still incipient, there are only 123 doctors specialized in PC, 340 services, but none with a hospice model. Therefore, the emergency room is the main access for these patients2. Objectives: To identify and characterize the demand of patients eligible for PC through the eligibility scales: Supportive and Palliative Care Indicators Tool (SPICT-BR) and the functionality scale "Palliative Performance Scale" (PPS), in emergency services in a city of 1 million inhabitants in the state of São Paulo (SP), Brazil. This is an observational, cross-sectional, multicenter study involving four emergency services in this metropolis of SP, Brazil. Being two public service and school hospital, and two private service. Interviews were conducted with patients admitted to the emergency rooms, and the following eligibility scales were applied: SPICT-BR and PPS, determining the incidence of eligible patients, comparisons between public and private services, and associations with the main comorbidities and symptoms. Results: A total of 293 interviews were conducted, of which 23 were excluded, leaving 270 patients for analysis. Of this population sample, 101 (37.4%) patients were eligible for PC, 82 (53.2%) were in the public service and 19 (16.4%) in the private service. Neoplasia was the most prevalent disease, affecting 37 (36.6%) patients, and pain was the main symptom affecting 28 (27.7%) patients. There was a high number of patients eligible for PC who come to emergency departments with uncontrolled symptoms, leading to congestion of the emergency departments and avoidable suffering. This fact stems from the lack of PC Services and Model Hospice in the country. Thus, there is a need for efficient public policies related to PC and Hospice Quality Improvement; Models of Palliative Care Delivery [ABSTRACT FROM AUTHOR]