Evaluation of packaged funding programs for palliative and hospice care by the National Health Service of Ukraine

Abstract

Financing of Palliative and Hospice Care (PHC) for adults and children in Ukraine is carried out from the state budget under the Medical Guarantee Programs (MGP) by the National Health Service of Ukraine (NHSU). In the professional medical environment and in the Ukrainian society, an active discussion about the list of pathologies of adults and children that require PCD, about the availability of palliative care, the effectiveness of hospices, palliative departments, wards of specialized and multidisciplinary hospitals, mobile teams, "home hospices", the availability of effective analgesia, demand for euthanasia, Ukrainian society's readiness for it continues. An important practical issue of the PHC organization is the list of medical and related services that are needed by palliative patients and that are financed by the NHSU. Working groups of specialists invited by the NHSU for expert evaluation of the list of such services constantly make corrections to the list in accordance with the feedback that exists between the NHSU and medical institutions of Ukraine that have concluded contracts for the PHC provision. This review is devoted to the analysis of changes in the list of medical services for palliative patients in accordance with the MGP. Financing of medical services provided to Ukrainians by medical institutions under the MGP began in Ukraine in 2020, when more than 1,600 specialized medical institutions concluded contracts with the NHSU under MGP, which provided services worth more than 100 billion UAH, and 123.5 billion UAH in 2021. And in 2011–2019, only a few dozen medical institutions provided PHC in Ukraine. We concluded that the MGP and package financing of PHC by the NHSU significantly expanded the capabilities of medical institutions of Ukraine to provide such care and cover the majority of patients who need it. Medical facilities must fulfill the minimum requirements of a significant volume to obtain the right to provide palliative care for budget funds. Keywords: PHC, medical guarantee programs, NHSU, health care financing.