The issue of patient-oriented organization of palliative and hospice care in Ukraine

Abstract

The quality of the provision of palliative and hospice care (PHC) depends on regulatory, legal and logistical support, the practice of implementing laws, and the support of society. The need for PHC is growing both worldwide and in Ukraine, which is associated with the aging of the population and global medical advances, thanks to which people live to a greater age and continue to live even with serious diseases and severe disabilities. Patients with incurable diseases most often need analgesia, which in low- and middle-income countries the population either does not receive at all, or has limited access to narcotic analgesics. The task of the PHC organization corresponds to the European integration obligations of Ukraine at a high level, and is in the sphere of responsibility of the Ministry of Health. The insufficient level of development of the national PHC system depends on imperfect legislation, non-implementation of adopted laws, lack of public results of calculating the need for PHC among adults and children. The system of training medical workers to work in hospices and palliative care departments, which concerns both doctors and nurses, also needs improvement. The routes of movement of palliative patients during the provision of assistance to them in the institutions of the health care system require public discussion. Instructions regarding the movement of these patients should be understandable to a doctor of any specialty, and contain step-by-step algorithms of actions. The practice of euthanasia, which is not allowed in Ukraine, is important for palliative patients. The PHC system should become one of the key components of the health care system, provided at the place of residence of patients (in hospices and palliative departments of hospitals) in the area where they live, or in "hospices at home". The development of the national PHC system, in which all known shortcomings will be taken into account and corrected, will be able to reduce the level of suffering of terminally ill patients and their relatives, and ensure their standard of living at the average European level.

Keywords: PHC, need for medical assistance, health care financing.