Keywords
medical guarantee programs
NHSU
health care financing
How to Cite
Abstract
Financing of Palliative and Hospice Care (PHC) for adults and children in Ukraine is carried out from the state budget under the Medical Guarantee Programs (MGP) by the National Health Service of Ukraine (NHSU). In the professional medical environment and in the Ukrainian society, an active discussion about the list of pathologies of adults and children that require PCD, about the availability of palliative care, the effectiveness of hospices, palliative departments, wards of specialized and multidisciplinary hospitals, mobile teams, "home hospices", the availability of effective analgesia, demand for euthanasia, Ukrainian society's readiness for it continues. An important practical issue of the PHC organization is the list of medical and related services that are needed by palliative patients and that are financed by the NHSU. Working groups of specialists invited by the NHSU for expert evaluation of the list of such services constantly make corrections to the list in accordance with the feedback that exists between the NHSU and medical institutions of Ukraine that have concluded contracts for the PHC provision. This review is devoted to the analysis of changes in the list of medical services for palliative patients in accordance with the MGP. Financing of medical services provided to Ukrainians by medical institutions under the MGP began in Ukraine in 2020, when more than 1,600 specialized medical institutions concluded contracts with the NHSU under MGP, which provided services worth more than 100 billion UAH, and 123.5 billion UAH in 2021. And in 2011–2019, only a few dozen medical institutions provided PHC in Ukraine. We concluded that the MGP and package financing of PHC by the NHSU significantly expanded the capabilities of medical institutions of Ukraine to provide such care and cover the majority of patients who need it. Medical facilities must fulfill the minimum requirements of a significant volume to obtain the right to provide palliative care for budget funds.
Keywords: PНC, medical guarantee programs, NHSU, health care financing.
References
Palliative care. Key facts. WHO, 5 Aug 2020. Available at: https://is.gd/o0NtI8
Assessing national capacity for the prevention and control of noncommunicable diseases: report of the 2019 global survey. Geneva: World Health Organization; 2020. 101 p. Available at: https://www.who.int/publications/i/item/9789240002319
Nesterenko VG. The need for palliative and hospice care in Ukraine in 2018–2020. Medicine Today and Tomorrow. 2021;90(3):43-52. DOI: msz.2021.90.3.nes [in Ukrainian].
Nesterenko VG. Forecasting the need for palliative and hospice care in Ukraine for 2021–2022. Experimental and Clinical Medicine. 2021;90(4):25-34. DOI: ekm.2021.90.4.nes [in Ukrainian].
Holovanova IA, Shevchenko AS. The issue of patient-oriented organization of palliative and hospice care in Ukraine. Experimental and Clinical Medicine. 2021;90(2):21-7. DOI: 10.35339/ekm.2021.90.2.hos.
Huzii O. Patient-oriented statistics and palliative care in Ukraine. Ukrainian medical journal. Available at: https://api.umj.com.ua/wp/wp-content/uploads/2017/08/Paliativ.pdf [in Ukrainian].
National strategy for reforming the healthcare system in Ukraine for the period 2015–2025 (2014 project). Available at: https://ips.ligazakon.net/document/NT1138 [in Ukrainian].
Chornyi OV. Peculiarities of reforms in public health care policy in European countries in the transformation period: historical and socio-economic aspects. Public administration and customs administration. 2020;3(26):78-82. DOI: 10.32836/2310-9653-2020-3.12. [In Ukrainian].
Krynychko LR, Liakhovych HI. Assessment of the consequences and results of health system reform in Ukraine. Public administration: improvement and development. 2020;(4):8p. DOI: 10.32702/2307-2156-2020.4.67. DOI: 10.32702/2307-2156-2020.4.67. [In Ukrainian].
Lehan VM, Kryachkova LV, Zayarsky MI. Analysis of health care reforms in Ukraine: from gaining independent to the present. Ukraine. Nation’s Health. 2018;4(52):5-11. Available at: https://is.gd/0ZXFOm [in Ukrainian].
Krynychko L. Stages of reforming the healthcare system in independent Ukraine. Litopys Volyni [Chronicle of Volyn]. 2021;(22):104-11. DOI: 10.32782/2305-9389/2020.22.17. [In Ukrainian].
Shevchenko VV. The reform of the higher education of Ukraine in the conditions of the military-political crisis. International Journal of Educational Development. 2018;65:237-53. DOI: 10.1016/j.ijedudev.2018.08.009.
Ustinov OV. Implementation of the Medical Guarantee Program in 2020. Ukrainian Medical Journal, 1 Apr 2021. Available at: https://www.umj.com.ua/uk/novyna-203097-realizatsiya-programi-medichnih-garantij-u-2020-r [in Ukrainian].
Ustinov OV. Palliative care in the Medical Guarantee Program-2021. Ukrainian Medical Journal, 5 Apr 2021. Available at: https://www.umj.com.ua/uk/novyna-203364-paliativna-dopomoga-u-programi-medichnih-garantij-2021 [in Ukrainian].
Cowey E, Schichtel M, Cheyne JD, Tweedie L, Lehman R, Melifonwu R, Mead GE. Palliative care after stroke: A review. International Journal of Stroke. 2021;16(6):632-9. DOI: 10.1177/17474930211016603.
Anzai T, Sato T, Fukumoto Y, Izumi C, Kizawa Y, Koga M, et al. JCS/JHFS 2021 Statement on Palliative Care in Cardiovascular Diseases. Circulation Journal. 2021;85:695-757. DOI: 10.1253/circj.CJ-20-1127.
Variations in Place of Death in England. Inequalities or appropriate consequences of age, gender and cause of death? UK: National End of Life Care Intelligence Network; 2010. 88 p. Available at: https://is.gd/me0gTI
Ustinov OV. PMG-2021 requirements: mobile palliative care. Ukrainian Medical Journal, 19 Mar 2021. Available at: https://www.umj.com.ua/uk/novyna-202089-vimogi-pmg-2021-mobilna-palativna-dopomoga [in Ukrainian].
Ustinov OV. Project of PMG requirements for 2021: inpatient palliative care. Ukrainian Medical Journal, 25 Sep 2020. Available at: https://www.umj.com.ua/uk/novyna-189211-proyekt-vimog-pmg-na-2021-rik-statsionarna-paliativna-dopomoga [in Ukrainian].
International Narcotics Control Board (UN). Precursors and Chemicals Frequently Used in the Illicit Manufacture of Narcotic Drugs and Psychotropic Substances: Reports E/INCB/2019/1-4 for 2019. Vienna: UN, 2020. 502 p. Available at: https://www.incb.org/documents/Narcotic-Drugs/Technical-Publications/2019/Narcotic_Drugs_Technical_Publication_2019_web.pdf [in English, French and Spanish].
WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents. Geneva: World Health Organization; 2018. 142 р. Available at: https://www.who.int/publications/i/item/9789241550390
Order of the Ministry of Health of Ukraine No.1308 on 4 Jun 2020 "On improving the organization of palliative care in Ukraine." Legislation of Ukraine. Verkhovna Rada (Parliament) of Ukraine. In force on 20 Jun 2021. Available at: https://zakon.rada.gov.ua/laws/show/z0609-20#n7 [in Ukrainian].