| Summary: | Aim
To assess how differences in structure and funding of health care systems in the UK and USA impact on the delivery and quality of end of life care.
Background
An increasingly ageing population results in the experience of dying becoming part of normal healthcare delivery. The structure and funding of each healthcare system is very different. The UK healthcare system is available to all through taxation of the public. The US healthcare system is based on individual insurance policies and private medicine. Due to government changes in each country, both healthcare systems are experiencing transformations in the structure and organisation of healthcare.
Method
A critical review was the chosen method and a variety of databases were used providing a range of sources and types of literature.
Findings
The majority of people in the UK and the US die in hospitals despite the preferred place of death being at home. The USA spends more of their GDP on healthcare each year compared to the UK. The UK provides universal healthcare compared to the USA providing varied healthcare on the ability to pay. The use of hospice care is also varied in each system. Advance directives are used more in practice in the USA, whereas the uses of such documents in the UK have not been widely used until recent years. Finally, the ideology of healthcare and end of life care also differ between the two cultures in the US and the UK.
Conclusion
There is no clear result or healthcare system that is better at delivering end of life care. Thus funding and organization of a healthcare system is not a very good indicator of good end of life care. Instead, other factors, including ideology, complexity of systems, and limitations of delivering care, influence good end of life care in practice. Therefore, the practice of nursing patients at the end of life is very complex.
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