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Автор: Valentina Nesterenko, candidate of medical sciences, associate professor of the department of Public Health and Health Care Management of Kharkiv National Medical University, Kharkiv, Ukraine; Victor Ohniev, doctor of medical sciences, professor, head of the department of Public Health and Health Care Management of Kharkiv National Medical University, Kharkiv, Ukraine; Mykola Hryhorov, assistant of the department of Public Health and Health Care Management of Kharkiv National Medical University, Kharkiv, Ukraine
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Palliative and hospice care (PHC) is intended for patients with terminal illnesses. Such assistance is provided with the aim of alleviating their suffering and improving the quality of life [1; 2]. In 2021, we calculated the need for PHC for adults and children of Ukraine according to the methodology of the Ukrainian Center for Public Data [3]. The methodology involves determining the need for PCBs in adult patients with malignant neoplasms, cardiovascular diseases, tuberculosis, diabetes, rheumatoid arthritis, fibrosis and cirrhosis of the liver, chronic obstructive pulmonary disease (COPD), HIV/AIDS, kidney disease; children with cerebral palsy, malignant neoplasms, diabetes, HIV/AIDS, inflammatory diseases of the central nervous system, cardiovascular diseases, severe perinatal conditions, tuberculosis, phenylketonuria, cystic fibrosis, chronic hepatitis, mucopolysaccharidoses and congenital malformations (calculated adult dementias and severe and profound mental retardation of children are excluded). We determined the total need for PHC for adults and children in 2019 – 261,201; in 2020 – 235,536 [4]. We considered the decrease in the need for PHC from 2018 to 2020 as a deterioration in the collection of statistical data, and not as an improvement in the situation.
A significant part of the need for PHC is the need of patients with bronchopulmonary diseases: COPD, pulmonary tuberculosis, cystic fibrosis, malignant neoplasms with pulmonary localization. The calculated need for PHC is influenced by a number of factors related to both the organization of medical care and the behavior of the patients themselves and their family members: patient participation in treatment, smoking cessation, patient nutrition at home (affects the frequency of referrals for medical care and duration of hospitalization), a conscious decision about where the patient wants to die (in the hospital or at home), whether to carry out resuscitation with the use of artificial lung ventilation in the future, perception of his illness (affects the required amount of painkillers) [5]. Also, we consider it expedient, starting from 2021, to calculate the need for PHC of patients with COPD together with the need for PHC of patients with COVID-19.
References:
1. Nesterenko VG. On the procedure for providing palliative and hospice care in Ukraine. Medicine Today and Tomorrow. 2021;90(2):57-62. https://doi.org/10.35339/msz.2021.90.2.nes [in Ukrainian].
2. What Are Palliative Care and Hospice Care? USA: National Institutes of Health. [Internet]. Available at: https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care [Accessed 07 Mar 2023].
3. The need for palliative care: an assessment based on 2018 data. Ukrainian Center for Public Data. [Internet]. Available at: https://socialdata.org.ua/palliative/ [Accessed 07 Mar 2023]. [In Ukrainian].
4. Nesterenko VG. The need for palliative and hospice care in Ukraine in 2018–2020. Medicine Today and Tomorrow. 2021;90(3):43-52. https://doi.org/10.35339/msz.2021.90.3.nes [in Ukrainian].
5. Mejza F. Management of chronic obstructive pulmonary disease. Summary of GOLD 2020 clinical guidelines. Part 1. Empendium. [Internet]. Available at: https://empendium.com/ua/chapter/B27.8.3.103.# [Accessed 07 Mar 2023]. [In Ukrainian].
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