The ranking was developed in three phases. First, we undertook an extensive scoping review that identified the core domains of end-of-life care that matter most to patients and caregivers. Using the results of the review, we developed a set of 13 indicators that can be used to assess the quality of EOL care delivery across key EOL care domains. Second, using these indicators, a discrete choice experiment (DCE) survey was developed and fielded to 1,250 caregivers of recently deceased care recipients across five countries (India, Kenya, Singapore, UK, USA) to generate relative importance weights for each level of each indicator. The preference weights for the 13 indicators are presented below:

Relative Importance for Each Indicator

Note: Error bars indicate 95% Confidence intervals

Third, to generate the comparison, we developed a survey instrument that included all 13 indicator questions, along with detailed explanations, and fielded it to country experts around the world. The experts were asked to respond (through five Likert response options ranging from strongly disagree to strongly agree), using their best judgement, whether they feel their country performs highly for each indicator.

Details on each of the above-mentioned tasks undertaken to produce the ranking can be read here:

Task 1: Scoping Review to Identify Core Domains to Assess the ‘Quality of Death’.

Task 2: Discrete Choice Experiment To quantify Preference Weights for Key EOL care indicators.

Task 3: Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021.