About the Conditions, Issues and Problems of Children Palliative Care Using the Example of the Children's Hospice Activity in Saint Petersburg

Abstract

The topicality of reforming the children palliative care (CPC) system due to the increase of the number of patients with cancer, congenital disorders, neurological damages, injuries consequences, genetically determined pathologies is discussed. The patterns of CPC service development, the importance to track those in need, to determine the required volume, forms, and methods of palliative care, and to develop human capacity were analyzed. The results of “Children's Hospice" (Saint Petersburg) activities in 2014-2019 years are presented alongside with the data on CPC development in Russia. This example shows the advantages of clear routing, establishment of indications for patients’ hospitalization, and availability of high-technology medical care and medications. All innovations have led to the significant change in medical conditions structure (over 80% of patients are children with neurological pathology), to the decrease in the number of hospitalizations, to the increase in the number of children who can get required respiratory support at home. The issues of high employees’ turnover and low staffing level in CPC institutions are discussed.