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Calculating the need for palliative and hospice care (PHC) is one of the most important aspects of planning national and regional budgets in the field of healthcare for terminally ill patients. According to our calculations, made in accordance with the methodology of the Ukrainian Center for Public Data, in 2018–2020 such a need gradually decreased both among the adult population and among children (from 258,207 in 2018 to 213,739 in 2020 among adults, and from 65,906 to 49,000 among children respectively). However, according to the calculation, the need was still several times higher than the assistance financed by the National Health Service of Ukraine (NHSHU) according to the applications of hospitals submitted to the NHSHU. The conducted research made it possible to clarify the calculation we made earlier and perform forecasting using the trend method for 2021 and 2022. Taking into account the downward trend in need, in 2021 the projected need was 194,537 among adults and 48,261 among children. In 2022, the projected need was 172,303 among adults and 45,517 among children. The marked gradual decrease in both the calculated (in 2018–2020) and predicted (in 2021 and 2022) need for PHC for adults and children, which, unfortunately, we do not associate with the decrease in morbidity associated with the establishment of palliative diagnoses, but with a decrease in the quality of the collection of medical statistical information, on which the calculation of the need for medical assistance is based. The analysis of the forecasting results can be refined in the future according to the forecasts of the number of diseases among adults and children, respectively, for the following years for diseases that correspond to the palliative diagnoses of the calculation. The performed forecasting is the basis for planning the financing of the health care sector. Keywords: palliative and hospice care for children, palliative and hospice care for adults, trend forecasting.
Calculating the need for palliative and hospice care (PHC) is one of the most important aspects of planning national and regional budgets in the field of healthcare for terminally ill patients. According to our calculations, made in accordance with the methodology of the Ukrainian Center for Public Data, in 2018–2020 such a need gradually decreased both among the adult population and among children (from 258,207 in 2018 to 213,739 in 2020 among adults, and from 65,906 to 49,000 among children respectively). However, according to the calculation, the need was still several times higher than the assistance financed by the National Health Service of Ukraine (NHSHU) according to the applications of hospitals submitted to the NHSHU. The conducted research made it possible to clarify the calculation we made earlier and perform forecasting using the trend method for 2021 and 2022. Taking into account the downward trend in need, in 2021 the projected need was 194,537 among adults and 48,261 among children. In 2022, the projected need was 172,303 among adults and 45,517 among children. The marked gradual decrease in both the calculated (in 2018–2020) and predicted (in 2021 and 2022) need for PHC for adults and children, which, unfortunately, we do not associate with the decrease in morbidity associated with the establishment of palliative diagnoses, but with a decrease in the quality of the collection of medical statistical information, on which the calculation of the need for medical assistance is based. The analysis of the forecasting results can be refined in the future according to the forecasts of the number of diseases among adults and children, respectively, for the following years for diseases that correspond to the palliative diagnoses of the calculation. The performed forecasting is the basis for planning the financing of the health care sector. Keywords: palliative and hospice care for children, palliative and hospice care for adults, trend forecasting.
To provide palliative and hospice care in Ukraine, specialized medical facilities have been created, the work of which reflects the advanced capabilities of the organization of medical care, and will also provide an insignificant part the total consumption of the population of certain regions, and the level of such demand covered by other indicators. A communal non-profit enterprise of the Kharkiv region "Regional Center for Palliative Medicine "Hospice"" (hereinafter referred to as Hospice), created in the region in 1999, provides palliative care to critically ill patients, especially an oncology illnesses and degenerative diseases of the nervous system. We carried out an analysis of the activity of the medical sector based on the indicators of personnel security and the characteristics of patients for the period 2016–2022, with the equalization of educational indicators in the military and pre-war hours. It was established that throughout the period of investigation, the Kharkov Hospice experienced a significant staffing shortage, which in an insignificant way increased due to the beginning of a full-scale war, but did not affect the performance of patient care. The mortality rate for the period 2018–2022 ranges from 3–8%, and this is due mainly to patients who are admitted to treatment rather than those who receive medical assistance. Most patients of the Kharkiv Hospice are women aged 70 years or more. The number of patients who were admitted to hospital before the medical emergency changed in 2022, which may be due to demographic problems in the region during the war, the marriage of budgetary funding and personnel shortages, and so on. We provide a large number of patients with comfortable conditions to provide medical care important palliative diagnoses and more important ones. The mortgage demonstrates high adaptability to the minds of wartime, and there is also a slight decline in the categories of patients who need help, with the constant needs of patients in the region. Keywords: lethality, need for PHC, staffing, adaptation to wartime conditions.
The provision of palliative and hospice care (PHC) is associated with significant material costs of the budgetary funding of countries, provided that these countries pay the necessary attention to these types of care. Ukraine strives for a model of increasing PHC coverage of those categories of patients recommended by WHO as best practices. This is especially important in the context of the growing number of patients in need of PHC both in Ukraine and around the world. The purpose of the study is to determine the need for the main types of PHC for the population of Ukraine in 2018–2020 according to the methodology proposed by the Ukrainian Center for Public Data. The methodology involves the use of data from national statistics centers (the State Statistics Service of Ukraine and the Center for Medical Statistics of the Ministry of Health of Ukraine), national cancer and tuberculosis registries (mainly on the number of deaths and those discharged from hospitals with the corresponding diagnosis), to which empirical coefficients from 0.2 to 0.9 are applied, determined by experts. As a result of the research, we determined the absolute values and trends regarding the need for the main PHC types for adults and children of Ukraine in 2018–2020. The need in absolute values among adults was 227,143; 212,199 and 190,179; among children – 61,355; 49,002 and 45,357; respectively. The greatest need for PHC among adults during this period was noted for malignant neoplasms and cardiovascular diseases, and among children – for congenital malformations, certain perinatal conditions, cerebral palsy, and malignant neoplasms. The overall need for PHC had a steady downward trend both among adults (by 16.27%) and among children (by 26.07%). The largest relative declines among adults during this period were recorded for rheumatoid arthritis, diabetes, and HIV/AIDS, and among children – for congenital malformations, inflammatory diseases of the central nervous system, and cardiovascular diseases. Keywords: palliative and hospice care for children, palliative and hospice care for adults, PHC, state medical statistics.
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