{
  "abstract": "Background: Discussions about end-of-life treatment preferences and advance directives are key elements of patient-centred care. Comparing perspectives of patients and primary care physicians can help identify gaps and inform policy.\n\nMethods: Data from the Commonwealth Fund’s International Health Policy Survey for adults aged 65 and older (2024) and primary care physicians (2025) were analysed for 10 EU/OECD countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the UK and the US).\n\nResults: Germany shows comparatively high levels of end-of-life care planning. In 2024, 83% of older adults reported having discussed end-of-life wishes with someone close or a doctor. 66% had a written advance directive. Much lower levels were observed in France (38% and 12%) and Sweden (31%, 6%), while the United States showed intermediate values (74%, 54%). Physician engagement also varies. In Germany, 88% of physicians reported discussing end-of-life wishes with patients, compared to higher levels in the Netherlands (99%) and the United Kingdom (96%), and lower levels in the United States (73%), Sweden (80%), and France (81%). Over time, Germany has seen a steady increase in advance care planning, with discussions of end-of-life wishes rising from 72% (2014) to 83% (2024) and existing advance directives from 57% to 66%.\n\nConclusions: Country variations point to the key role of national policies and health system organisation in end-of-life care planning. Greater involvement of both patients and primary care physicians could lead to higher levels of end-of-life care planning. Comparatively high and increasing levels of end-of-life care planning can be observed in Germany, both from patient and physician perspective. However, whereas end-of-life wishes have been discussed widely, this has only partly resulted in advance directives.International comparisons provide valuable insights to strengthen patient-centred end-of-life care.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "abstract",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "A Wengler"
    },
    {
      "name": "LM Foaleng Gamgne"
    },
    {
      "name": "F Prütz"
    },
    {
      "name": "J Allen"
    },
    {
      "name": "H Lachenmaier"
    },
    {
      "name": "A Meier"
    },
    {
      "name": "A Rommel"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/96tvczw8vt3rm.bib",
  "cited_by": 0,
  "doi": "10.1093/eurpub/ckag169.561",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699506/",
  "id": "96tvczw8vt3rm",
  "issns": [
    "1101-1262",
    "1464-360X"
  ],
  "landing_url": "https://doi.org/10.1093/eurpub/ckag169.561",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "3. PARALLEL PROGRAMME"
    ],
    [
      "heading",
      "AcademicSubjects/MED00860"
    ],
    [
      "heading",
      "AcademicSubjects/SOC01210"
    ],
    [
      "heading",
      "AcademicSubjects/SOC02610"
    ],
    [
      "openalex",
      "2739|Palliative Care and End-of-Life Issues"
    ]
  ],
  "openalex": "W7223659262",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13699506/pdf/?tool=EBI",
  "pmcid": "PMC13699506",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "Oxford University Press",
  "ris": "https://research.draconitic.com/paper/96tvczw8vt3rm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "PMC13699506",
      "source": "pmc",
      "url": "https://doi.org/10.1093/eurpub/ckag169.561"
    },
    {
      "first_seen": "2026-10-30T12:21:40Z",
      "native_id": "PMC:PMC13699506",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13699506"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Palliative Care and End-of-Life Issues",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Advance Directives and End-of-Life Wishes: Perspectives of Patients and Physicians in OECD countries",
  "title_text": "Advance Directives and End-of-Life Wishes: Perspectives of Patients and Physicians in OECD countries",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:36:04Z",
  "url": "https://research.draconitic.com/paper/96tvczw8vt3rm",
  "venue": "The European Journal of Public Health",
  "versions": []
}