Calculation of the need for resources of the health care system to provide palliative care to the population of Ukraine in 2018–2020

Abstract

Financing of the needs of the health care system of Ukraine at the current stage takes place in the form of payment for packages of contracted services by the National Health Service of Ukraine. One of these packages is palliative and hospice care (PHC). In the professional environment, there is a debate about the composition of this package and the amount of funding. The right to PHC is one of the important components of the general right of Ukrainians to health care, and it must be ensured both from the point of view of medical ethics and to fulfill Ukraine's international obligations. The calculation of the amount of PHC financing is carried out in accordance with the data of demographic statistics (in particular, the number of available adult population and children aged 0–14), the calculated number of patients who need PHC, the availability of hospices, palliative departments and beds, as well as the possibility of their creation/deployment, presence of field (mobile) PHC teams, which should provide approximately 60% of such assistance. The study calculated the need for the Ukrainian PHC system in personnel and material resources: the number of palliative departments and beds, mobile teams, doctors and nurses, for the period 2018–2020. It was established that the minimum and optimal number of required palliative departments during this period ranged from 83 to 257 for adults and 19 to 66 for children, the number of required beds was (1,136–1,434) and (576–629), outpatient (mobile) services – (259–517) and (59–396), inpatient doctors – (215–285) and (118–52), inpatient nurses – (568–1,720) and (104–944), doctors of mobile teams – (518–2,066) and (118–1,582), nurses of mobile teams – (518–6,197) and (118–4,746), respectively. Factors that can cause calculation errors (specificity of treatment and prevention facilities in the regions, the presence of palliative patients in a small number who should be provided with help at home), other limitations of the study are established. Keywords: hospices, mobile palliative care services, human resources, contracted medical services.