Palliative Care in the Kyrgyz Republic

Abstract

Abstract 55 Currently, there are 22,984 cancer patients registered in the Kyrgyz Republic. In 2014, 5,552 new patients were diagnosed with malignant tumors and 3,219 of them died the same year. Total cancer rates in the country are steadily growing with 89.1 cases/100,000 population in 2012, 89.6 cases/100,000 population in 2013 and 95.1 cases/100,000 population in 2014. With growing cancer prevalence, need for accessible and sustainable palliative care system is rapidly increasing. In 2012, a Strategy of Palliative Care Development in the Kyrgyz Republic for 2012-2016 was proposed to address provision of patient palliative care in the country. As a result, the Kyrgyz government accepted a policy of referring patients to Palliative care facilities based on medical diagnosis and, therefore, these services must be monitored for quality control. We examined developmental progress of palliative care system in the Kyrgyz Republic and its outcomes. Data were collected from 453 terminal cancer patients registered in the Department of Palliative Care of the National Oncology Center. We used the average length of stay and the subsequent place of care as process indicators, as well as changes in the mean pain score as outcome measurements. There were considerable variations among services with regards to the mean length of stay (i.e., 6 to 28 days for each admission) and subsequent place of care, even after stratification by service level. The mean change in average pain score varied from −1.5 to 2.1, and remained significant after case-mix adjustment. We discovered significant variations in palliative care services quality in relation to the average length of stay, subsequent places of care as well as alterations in the average pain score. Continuous evaluation of changes in the establishment and outcomes of palliative care services will assist in the development of comparative analysis and evaluation of public policies of the national Palliative Care system. In accordance with the Soros Foundation-Kyrgyzstan, a new initiative is currently being implemented by the National Center of Oncology: “Creating an integrated palliative care service model at home.” The purpose of this project is expansion of home-based end-of-life services provided by a multidisciplinary team for terminal patients in the city of Bishkek. As a part of the initiative, 87 patients have already received home-based palliative care assistance. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from either author.