Integration Capacity Score (ICS)*†
| Integration capacity level (n of countries) | Country | Types of OECD§ healthcare systems‡ | Paediatrics (max 9) | Cardiology (max 8) | Oncology (max 7) | Primary care (max 7) | Long-term care (max 12) | Volunteering (max 10) | ICS (max 53) |
| High (n=4) | The Netherlands | Etatist SHI | 9 | 7 | 6 | 7 | 12 | 10 | 51 |
| UK | NHS | 8 | 8 | 6 | 6 | 12 | 7 | 47 | |
| Germany | SHI | 7 | 5 | 6 | 6 | 11 | 8 | 43 | |
| Switzerland | SHI | 5 | 5 | 7 | 5 | 9 | 9 | 40 | |
| Intermediate (n=8) | Belgium | Etatist SHI | 6 | 0 | 7 | 4 | 12 | 9 | 38 |
| Czech Republic | Etatist SHI | 6 | 7 | 4 | 4 | 7 | 8 | 36 | |
| Denmark | NHS | 9 | 7 | 6 | 5 | 9 | 0 | 36 | |
| Italy | NHI | 4 | 5 | 7 | 4 | 10 | 6 | 36 | |
| Poland | Etatist SHI | 7 | 0 | 5 | 5 | 10 | 8 | 35 | |
| Spain | NHS | 5 | 8 | 6 | 7 | 9 | 0 | 35 | |
| Austria | SHI | 7 | 0 | 6 | 0 | 11 | 10 | 34 | |
| France | Etatist SHI | 6 | 0 | 6 | 2 | 12 | 7 | 33 | |
| Low (n=18) | Kyrgyz Republic | 4 | 0 | 3 | 7 | 12 | 0 | 26 | |
| Hungary | Etatist SHI | 7 | 0 | 5 | 5 | 0 | 8 | 25 | |
| Ireland | NHI | 9 | 6 | 5 | 5 | 0 | 0 | 25 | |
| Portugal | NHS | 6 | 7 | 5 | 4 | 0 | 3 | 25 | |
| Serbia | – | 4 | 0 | 3 | 7 | 0 | 9 | 23 | |
| Albania | – | 7 | 4 | 3 | 5 | 0 | 2 | 21 | |
| Romania | – | 6 | 0 | 6 | 2 | 0 | 7 | 21 | |
| Israel | Etatist SHI | 7 | 0 | 6 | 0 | 7 | 0 | 20 | |
| Lithuania | – | 4 | 0 | 3 | 0 | 12 | 0 | 19 | |
| Sweden | NHS | 3 | 6 | 5 | 5 | 0 | 0 | 19 | |
| Armenia | – | 3 | 0 | 3 | 4 | 4 | 3 | 17 | |
| Greece | – | 4 | 0 | 4 | 2 | 7 | 0 | 17 | |
| Luxembourg | SHI | 7 | 0 | 3 | 7 | 0 | 0 | 17 | |
| Norway | NHS | 3 | 0 | 7 | 5 | 0 | 0 | 15 | |
| Slovenia | SBMT | 4 | 0 | 6 | 5 | 0 | 0 | 15 | |
| Moldova | – | 8 | 0 | 3 | 3 | 0 | 0 | 14 | |
| Russian Federation | – | 4 | 0 | 4 | 0 | 6 | 0 | 14 | |
| Turkey | – | 5 | 0 | 5 | 4 | 0 | 0 | 14 | |
| Very low (n=21) | Finland | NHS | 4 | 0 | 4 | 5 | 0 | 0 | 13 |
| Tajikistan | – | 4 | 0 | 3 | 5 | 1 | 0 | 13 | |
| Ukraine | – | 6 | 0 | 3 | 4 | 0 | 0 | 13 | |
| Kazakhstan | – | 4 | 0 | 3 | 5 | 0 | 0 | 12 | |
| Malta | – | 3 | 0 | 3 | 5 | 0 | 0 | 11 | |
| Belarus | – | 7 | 0 | 3 | 0 | 0 | 0 | 10 | |
| Cyprus | – | 3 | 0 | 4 | 3 | 0 | 0 | 10 | |
| Latvia | – | 7 | 0 | 3 | 0 | 0 | 0 | 10 | |
| Slovak Republic | Etatist SHI | 7 | 0 | 3 | 0 | 0 | 0 | 10 | |
| Georgia | – | 6 | 0 | 3 | 0 | 0 | 0 | 9 | |
| Bulgaria | – | 1 | 0 | 4 | 3 | 0 | 0 | 8 | |
| Croatia | – | 0 | 0 | 3 | 5 | 0 | 0 | 8 | |
| Estonia | Etatist SHI | 3 | 0 | 5 | 0 | 0 | 0 | 8 | |
| Azerbaijan | – | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| Bosnia and Herzegovina | – | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| Iceland | NHS | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| Liechtenstein | – | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| North Macedonia | – | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| Monaco | – | 3 | 0 | 3 | 0 | 0 | 0 | 6 | |
| Montenegro | – | 0 | 0 | 3 | 0 | 0 | 0 | 3 | |
| Uzbekistan | – | 0 | 0 | 3 | 0 | 0 | 0 | 3 |
*Available data from palliative care activity in six areas of the health system were rated to create an integration subscore by area explored: 0 point: no experts identified; 1 point: at least one expert was identified, but no reported activity data; 2 points: available activity data (if ordinal values are below the median); 3 points: ordinal activity data above the median. The country integration score (ICS) is obtained with the sum of the subscores of integrations in each area of the health system explored.
†Activity data of each health system area explored, as obtained in the European Association for Palliative Care Atlas survey, are available in online supplemental appendix 1.
‡Source: Böhm et al. 42
§OECD: The Organisation for Economic Co-operation and Development.
NHI, National Health Insurance; NHS, National Health Service; SBMT, social-based mixed type; SHI, social health insurance.