More attention and funding for palliative help

The second Saturday of October is World Hospice and Palliative Care Day. It aims to raise awareness of people with serious illnesses and their relatives, and to recognise the role of palliative care in providing help, comfort and support to sick people. Palliative care becomes increasingly important as the population ages and the number  of oncological and other life-threatening diseases increases.

What is palliative care?

Palliative care is a means of improving the quality of life of a patient with a life-threatening, incurable, progressive illness and their relatives by preventing or alleviating suffering and by helping them to cope with physical, psychosocial and spiritual problems. 

Palliative care can be provided to patients on an inpatient or outpatient basis.

Who receives inpatient palliative care?

Inpatient palliative care services are provided to adult patients whose health status meets established criteria. For example, all active treatment options (except chemotherapy, palliative chemotherapy, radiotherapy, biologic therapy, hormone therapy and dialysis) have been used to treat a disease, the disease is progressive and life threatening. These patients need symptomatic therapies that improve their quality of life and that of their loved ones.

For children with a progressive and life-threatening disease, inpatient palliative care services are available when symptoms need to be managed.

A referral for inpatient palliative care is given by an attending physician. A referral is not required when a patient is transferred from a palliative care and nursing department to a palliative care unit in the same healthcare facility. Inpatient palliative care is paid for by the Compulsory Health Insurance Fund (CHIF), without limiting the length of time it can be provided, and does not depend on whether or not the patient has already been provided with inpatient care and palliative treatment.

It is important to know that while a patient is receiving palliative care in the inpatient, medical aids (nappies, pads, disposable sheets, a disposable kit for a drug drip infusion pump, stoma and stoma skin care products, etc.) may not be prescribed. The hospital must provide these medical aids.

Help may be provided at home

Outpatient palliative help is not the same as care services at home. Palliative help is provided only to patients with terminal illnesses. When needed, it may be provided at patient’s home, day inpatient centre of palliative care, social care institution, educational institution, workplace.

A polyclinic or a family clinic where the patient is registered must provide outpatient palliative care. If the institution is not able to do so, it shall contract with another medical institution that can provide these services.

Outpatient palliative care is available to patients whose health status meets the same criteria as for inpatient palliative care.

Who works in the specialist team?

Outpatient palliative care services are provided up to 3 times a day per one person - adult or child. This amount of services is paid from the CHIF. Home services are provided daily from 8 AM to 8 PM, while inpatient day services are provided for a minimum of 4 hours and a maximum of 12 hours per day.

Outpatient palliative care is provided by a specialist team, which consists of a doctor, a nurse, a nurse assistant, a social worker, a medical psychologist, and a physiotherapist. The team is coordinated by a doctor, who may decide to include other specialists in the team.

A referral for outpatient palliative care services is also made by the attending doctor.

The number of outpatient services increases

According to the data of the National Health Insurance Fund under the Ministry of Health, this year territorial health insurance funds have concluded one-third more contracts with medical institutions for the provision of outpatient palliative care services than last year. Outpatient palliative care services amounted to EUR 3.1 million in the first half of this year, compared to a total of almost EUR 3.6 million for the whole year. It shows that services are important and the need for them increases.

In response to the growing demand for services, health insurance funds have already reimbursed  EUR 1.3 million to healthcare institutions for the first half of the year in excess of contract costs. The CHIF will also cover these costs for the second half of the year. The aim is to ensure that as many palliative care services as possible are provided on an outpatient basis.

In total, around EUR 13.6 million of CHIF funds are expected to be spent on inpatient and outpatient palliative care services under this year’s contracts with medical institutions. In the first half of the year, these services amounted to EUR 9.5 million. This represents almost 70% of the annual amount.

Information of Panevėžys territorial health insurance fund

(Freepic photo)

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