Background and Objectives:
In Italy, Palliative Care (PC) is included in the set of healthcare services guaranteed by the National Health Service (law 38/2010). Local Health Authority can adapt the PC system according to Regional guidelines. In the Emilia-Romagna Region, the PC network (PCN) consist of 4 knots: hospital, medical office, hospice and homecare. In Reggio Emilia province, PC services are built on multidisciplinary teamwork since 1988.

Methods:
All the patients with oncologic or non-oncologic disease and approaching end of life can enter the local PCN. The approach to care and its setting is evaluated by a multidisciplinary team, according to patient’s wishes. The place of care can be one of the PCN knots. Specialists in PC (including trained general practitioners), psychologists and nurses teamwork in PCN. The Primary Care Department of the Local Health Authority collects data and evaluate process and outcome indicators of the quality of care provided.

Results:
In 2021, 45 nurses and 33 PC specialists worked for the network, 70% and 50% part-time, respectively. In the same year, 2.017 patients were enrolled (+5% from 2020, +9% from 2019), 70% of them affected by cancer. Of all the oncologic patients died in 2021, 70% were taken care by PCN and 42% of them died at home. Patients that were taken care at home were followed for a median of 60 days.

Conclusion:
PC system plays an important role in ensuring the best quality of life for patients approaching end of life. Moreover, PC allows patient to die at home surrounded by their loved ones. An efficient teamwork and strong relationships between hospital and territory is the keystone to its success and to guarantee uniformity to care access. Cultural interventions towards the acceptance of palliative care should be considered in order to reach patients not enrolled.