<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022021000200113</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Necesidades de atención en cuidado paliativo de Costa Rica según provincia]]></article-title>
<article-title xml:lang="en"><![CDATA[Palliative care needs in Costa Rica by Province]]></article-title>
<article-title xml:lang="en"><![CDATA[Palliative care needs in Costa Rica by province]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Picado-Ovares]]></surname>
<given-names><![CDATA[José Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solórzano-Morera]]></surname>
<given-names><![CDATA[Flavia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Caja Costarricense del Seguro Social Hospital Nacional Geriátrico Raúl Blanco Cervantes ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>63</volume>
<numero>2</numero>
<fpage>113</fpage>
<lpage>121</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022021000200113&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022021000200113&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022021000200113&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Justificación y objetivo.  Existe un desconocimiento en relación con las necesidades de cuidados paliativos en Costa Rica lo que genera dificultades para poder distribuir los recursos adecuadamente. Este estudio busca identificar las necesidades de cuidado paliativo por provincia para que sirva de insumo para una adecuada planeación y utilización de los recursos.  Métodos. Se utilizó la metodología diseñada por la Lancet Commission on Palliative Care and Pain Relief basada en el sufrimiento grave relacionado con la salud para 20 enfermedades con mayor necesidad probable de atención paliativa utilizando la base de datos del Instituto costarricense de estadística y Censo y bases de datos del Ministerio de Salud y de la Caja Costarricense del Seguro Social.  Resultados. En Costa Rica, 19502 personas requirieron atención paliativa en el 2018, siendo las enfermedades neoplásicas las que ocupan el primer lugar, seguidas por enfermedades cerebrovasculares, causas externas y HIV-SIDA. La mayoría de los casos se ubican en las provincias del centro del país (San José, Alajuela y Heredia) y la minoría en Guanacaste.  Conclusiones.  Se logró estimar las necesidades de cuidado paliativo en Costa Rica por diagnósticos y provincia de domicilio documentando que la mayoría de las necesidades son por enfermedades terminales no oncológicas y en las provincias de San José, Alajuela y Heredia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background and aim.  There is a lack of knowledge regarding palliative care needs in Costa Rica, which creates difficulties in being able to distribute resources properly. This study seeks to identify palliative care needs by province to serve as input for adequate planning and utilization of resources.  Methods.  The methodology designed by the Lancet Commission on Palliative Care and Pain Relief based on severe health-related suffering was used for 20 diseases with the greatest probable need for palliative care using the database of the Costa Rican Institute of Statistics and Census and databases of the Ministry of Health and the Caja Costarricense del Seguro Social.  Results.  In Costa Rica, 19502 people required palliative care in 2018, with neoplastic diseases occupying the first place, followed by cerebrovascular diseases, external causes, and HIV-AIDS. Most of the cases are in the central provinces of the country (San José, Alajuela, and Heredia) and the minority in Guanacaste.  Conclusions.  It was possible to estimate the palliative care needs in Costa Rica by diagnoses and province of residence, documenting that the majority of needs are for non- oncological terminal diseases and in the provinces of San José, Alajuela and Heredia.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Necesidades]]></kwd>
<kwd lng="es"><![CDATA[Atención]]></kwd>
<kwd lng="es"><![CDATA[Cuidado Paliativo]]></kwd>
<kwd lng="en"><![CDATA[Needs]]></kwd>
<kwd lng="en"><![CDATA[Care]]></kwd>
<kwd lng="en"><![CDATA[Palliative Care]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>World Health Organization (WHO).</collab>
<source><![CDATA[Global Atlas of Palliative Care 2nd]]></source>
<year>2020</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[Worldwide Palliative Care Alliance]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Radbruch]]></surname>
<given-names><![CDATA[Lukas]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Redefining Palliative Care-A New Consensus-Based Definition.]]></article-title>
<source><![CDATA[Journal of Pain and Symptom Management.]]></source>
<year>2020</year>
<volume>60</volume>
<page-range>10.1016/j.jpainsymman.04.027</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Murtagh]]></surname>
<given-names><![CDATA[FE]]></given-names>
</name>
<name>
<surname><![CDATA[Bausewein]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Verne]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Groeneveld]]></surname>
<given-names><![CDATA[EI]]></given-names>
</name>
<name>
<surname><![CDATA[Kaloki]]></surname>
<given-names><![CDATA[YE]]></given-names>
</name>
<name>
<surname><![CDATA[Higginson]]></surname>
<given-names><![CDATA[IJ.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How many people need palliative care? A study developing and comparing methods for population-based estimates]]></article-title>
<source><![CDATA[Palliat Med.]]></source>
<year>2014</year>
<volume>28</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>49-58</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grbich]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Maddocks]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Parker]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Brown]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Willis]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Piller]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Hofmeyer]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identification of patients with noncancer diseases for palliative care services]]></article-title>
<source><![CDATA[Palliative and Supportive Care]]></source>
<year>2005</year>
<volume>3</volume>
<page-range>5-14</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Noble]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Finlay]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Nelson]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Defining the palliative care patient: its challenges and implications for service delivery.]]></article-title>
<source><![CDATA[British Medical Journal Support Palliative Care]]></source>
<year>2012</year>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rosenwax]]></surname>
<given-names><![CDATA[LK]]></given-names>
</name>
<name>
<surname><![CDATA[McNamara]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Blackmore]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Estimating the size of a potential palliative care population]]></article-title>
<source><![CDATA[Palliat Med]]></source>
<year>2005</year>
<volume>19</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>556-62</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gómez-Batiste]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Martinez-Munoz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Blay]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identifying needs and improving palliative care of chronically ill patients: a community- oriented, population-based, public-health approach.]]></article-title>
<source><![CDATA[Curr Opin Support Palliat Care]]></source>
<year>2012</year>
<volume>6</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>371-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8.</label><nlm-citation citation-type="book">
<collab>World Health Organization (WHO).</collab>
<source><![CDATA[Global Atlas of Palliative Care at the End of Life.]]></source>
<year>2014</year>
<publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[Worldwide Palliative Care Alliance]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Knaul]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lancet Commission on Palliative Care and Pain Relief Study Group. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report.]]></article-title>
<source><![CDATA[Lancet.]]></source>
<year></year>
<volume>391</volume>
<numero>10128</numero>
<issue>10128</issue>
<page-range>1391-1454.</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sleeman]]></surname>
<given-names><![CDATA[Katherine]]></given-names>
</name>
<name>
<surname><![CDATA[De Brito]]></surname>
<given-names><![CDATA[Maja]]></given-names>
</name>
<name>
<surname><![CDATA[Etkind]]></surname>
<given-names><![CDATA[Simon]]></given-names>
</name>
<name>
<surname><![CDATA[Nkhoma]]></surname>
<given-names><![CDATA[Kennedy]]></given-names>
</name>
<name>
<surname><![CDATA[Guo]]></surname>
<given-names><![CDATA[Ping]]></given-names>
</name>
<name>
<surname><![CDATA[Higginson]]></surname>
<given-names><![CDATA[Irene]]></given-names>
</name>
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[Barbara]]></given-names>
</name>
<name>
<surname><![CDATA[Harding]]></surname>
<given-names><![CDATA[Richard.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The escalating global burden of serious health-related suffering: projections to 2060 by world regions, age groups, and health conditions.]]></article-title>
<source><![CDATA[The Lancet Global Health]]></source>
<year>2019</year>
<volume>7</volume>
<numero>19</numero>
<issue>19</issue>
<page-range>30172-X</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11.</label><nlm-citation citation-type="">
<source><![CDATA[Lancet Commission on global access to palliative care and pain]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B12">
<label>12.</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[de la Peña]]></surname>
<given-names><![CDATA[Enrique]]></given-names>
</name>
<name>
<surname><![CDATA[Millares Lourdes]]></surname>
<given-names><![CDATA[Díaz Alejandro]]></given-names>
</name>
<name>
<surname><![CDATA[Bustamante]]></surname>
<given-names><![CDATA[Taddia Claudia]]></given-names>
</name>
</person-group>
<source><![CDATA[Experiencia de éxito: resumen ejecutivo]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Washington DC, EE.UU ]]></publisher-loc>
<publisher-name><![CDATA[Banco Interamericano de Desarrollo.]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bohián]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<source><![CDATA[Estadísticas de siniestros viales con víctimas en Costa Rica para el período 2012- 2016]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14.</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Páramo]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<source><![CDATA[Actualización en la prevalencia y carga de la enfermedad cerebrovascular en Costa Rica en el período comprendido entre 2009-2019.]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez Montero]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Rodríguez Montero]]></surname>
<given-names><![CDATA[P.]]></given-names>
</name>
</person-group>
<source><![CDATA[Aspectos epidemiológicos del virus de inmunodeficiencia humana en costa rica]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mata-Azofeifa]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Baraquiso Pazos]]></surname>
<given-names><![CDATA[M.]]></given-names>
</name>
</person-group>
<source><![CDATA[Análisis de la mortalidad por tuberculosis, en Costa Rica]]></source>
<year>2020</year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martyn]]></surname>
<given-names><![CDATA[CN]]></given-names>
</name>
<name>
<surname><![CDATA[Pippard]]></surname>
<given-names><![CDATA[EC.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Usefulness of mortality data in determining the geography and time trends of dementia.]]></article-title>
<source><![CDATA[J Epidemiol Community Health8]]></source>
<year>1988</year>
<volume>42</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>134-7</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fornaguera]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Segura]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Montero-Herrera]]></surname>
<given-names><![CDATA[B.]]></given-names>
</name>
</person-group>
<source><![CDATA[Enfermedad de Alzheimer en Costa Rica. Una realidad poco investigada]]></source>
<year>2018</year>
</nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chinchilla]]></surname>
<given-names><![CDATA[Jairo]]></given-names>
</name>
<name>
<surname><![CDATA[Evans-Meza]]></surname>
<given-names><![CDATA[Ronald]]></given-names>
</name>
<name>
<surname><![CDATA[Bonilla Roger]]></surname>
<given-names><![CDATA[Romero Águeda).]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evolución de la carga por enfermedades pulmonares crónicas en Costa Rica, 1990-2014.]]></article-title>
<source><![CDATA[REV HISP CIENC SALUD]]></source>
<year>2018</year>
<volume>4</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>65-77</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20.</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Field]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Addington-Hall]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Extending specialist palliative care to all?]]></article-title>
<source><![CDATA[Soc Sci]]></source>
<year>1999</year>
<page-range>1271-80</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Phillips]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[Reay]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Martyn]]></surname>
<given-names><![CDATA[CN.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Validity of mortality data for Parkinson&#8217;s disease]]></article-title>
<source><![CDATA[J Epidemiol Community Health.]]></source>
<year>1999</year>
<volume>53</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>587-58</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Li SQ]]></surname>
<given-names><![CDATA[Cass A]]></given-names>
</name>
<name>
<surname><![CDATA[Cunningham]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Cause of death in patients with end-stage renal disease: assessing concordance of death certificates with registry reports.]]></article-title>
<source><![CDATA[Aust N Z J Public Health]]></source>
<year>2003</year>
<volume>27</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>419-24</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
