Justification of the model of optimized system of providing palliative and hospice care to the population of Ukraine

Abstract

Background. National systems of Palliative and Hospice Care (PHC) are an important part of holistic systems of public health care. According to ratings (modified Wright М., Lynch T. and Clark D. country rating system, 2008/2011; Quality of Death Index, 2015), the PHC system of Ukraine is such that it does not have signs of systemic organization at the state level, provides low coverage of treatment and care of palliative patients (approximately 30% of the need) and the low quality of treatment (especially analgesia) of predominantly the majority (nearly 80%) of the covered patients. Aim. To substantiate the model of the optimized PHC system of Ukraine on the basis of the generalized experience of countries with developed PHC systems and the results of own scientific research; evaluate the developed model. Materials and methods. System analysis and comparative methods were used in the study. To evaluate the developed model, a sociological method was used: a survey of specialists in the organization of health care and PHC was carried out. The results of the survey are evaluated on a quartile scale (Q1–Q4). Results and conclusions. A model of the optimized system of providing PHC to the population of Ukraine was developed, which outlines the subjects and objects of management, the goal, strategy, tactics, functions of the improved management system, directions, methods, measures, resources, and the system of scientific regulation. Scientific, legal, economic and administrative solutions are proposed to improve the existing order of PHC organization. According to the parameters of reasonableness and consistency, the model was recognized by experts as high-quality (the assessment is within Q4[75–100]%). By parameters predictability, correlativeness and resistance to changes, as well as according to the general assessment, the model is recognized by experts as high-quality (the assessment is within Q3[50–75]%). The evaluation of the developed model allows us to propose it for use in the organization of health care in the conditions of long-term reform of the health care system and the uncertainty of wartime. Keywords: health care system reform, qualimetry, expert assessment.