In 2018-2021, more than UAH 40 million will be allocated from the city budget of Dnipro

The experience of building a palliative care system in the Dnipropetrovsk region can become a model for other regions, as local authorities, subject to political will, are able to find both time and resources to help their citizens. Since the beginning of 2018, the city palliative care program has been operational in Dnipro.

In his interview with the publication "Your Health", the head of the Dnipropetrovsk regional organization of the NGO "Ukrainian League for the Development of Palliative and Hospice Care" Yury Krynychnyi spoke about the current situation and plans for the development of palliative care in the region. According to him, nowthere are 132 beds for palliative patients in the region. 45 of them are located on the bases of several Dnipro hospitals, the rest operate in Kamianskyi (20 beds), Kryvyi Rih (20), Marganets (15), Nikopol (10), Shirokivskyi (15) and Pyatikhatskyi (7) districts. This number is only a quarter of the need, because according to the recommendation of the European Association of Palliative Care, there should be 10 hospice and palliative care beds per 100,000 population. Most of the patients - almost 80% - are patients with oncological pathology, some suffer from Parkinson's syndrome, Alzheimer's disease or other types of dementia, as well as HIV infection/AIDS and multi-resistant forms of tuberculosis.

In general, about 5 thousand patients need palliative care in Dnipropetrovsk Oblast. But it is not only a matter of counting the number of beds and patients. After all, palliative care is a whole complex of medical, social and psychological measures designed to ensure the highest possible quality of life for terminally ill patients, as well as support for their families. And, unfortunately, until today, as Krynychnyi notes, the region has not been able to provide such comprehensive assistance to patients and their relatives.

Last fall, an approved municipal palliative care program was presented in Dnipro, which came into effect on January 1, 2018. The main goal of the new program is to improve the palliative care system in outpatient settings to ensure a decent quality of life for people with incurable diseases by controlling the pain syndrome and other manifestations of the disease, as well as social, spiritual, and psychological support for patients and their relatives. "The draft document describes a clear mechanism of interaction between the medical service and social workers of territorial centers, psychologists, volunteers, and representatives of the clergy. The main thing is that all links of this system start to work in a comprehensive and coordinated manner," Yuriy Krynychnyi emphasized .

To ensure high-quality outpatient care for palliative patients in all twelve city centers of primary health care, it is planned to create special mobile teams to go to the patient's home - for this purpose, the purchase of additional transport is planned. In addition to a family doctor and a nurse, such teams will include a social worker and a psychotherapist, if necessary. After all, in addition to medical procedures (analgesia, dressings, etc.), many palliative patients also need social and psychological assistance.

In Dnipro, the only mobile multidisciplinary team will be created in the city, which will be able to provide consultation and diagnostic services (blood analysis, ECG, etc.) to terminally ill patients at home. It is planned that this team, at the request of the family doctor, will include narrow specialists necessary for a specific patient: an endocrinologist, a gastroenterologist, a surgeon and others. In essence, the team will become a connecting link between the primary and secondary levels of medical care.

In addition, the creation of so-called rental points of medical care for palliative patients (walkers, anti-bedsore mattresses) is foreseen, as well as providing patients with means of rehabilitation in outpatient settings (urine and calorimeters, diapers, etc.). The program includes the additional purchase of drugs and painkillers for palliative patients. In particular, in 2018, twice as much as in 2017, UAH 2.6 million, is planned to be allocated from the city budget to the treatment of chronic pain syndrome. In general, over 40 million hryvnias will be allocated from the city budget for the implementation of the city program of providing palliative care in outpatient settings for 2018-2021, of which about 9 million hryvnias are planned to be used this year.

The full version of the interview of the head of the Dnipropetrovsk regional organization of the NGO "Ukrainian League for the Development of Palliative and Hospice Care" Yuri Krynychny can be found at the link http://www.vz.kiev.ua/dovgo-zapryagaly-odnak-shvydko-rushyly/