Organization of Palliative Care Provision in the Palliative Care Department During War Time

The city of Kyiv is characterized by a high level (258.6 cases per 100,000 population) of cancer incidence and mortality. The objective: to determine the problem and prospects of providing inpatient oncology care based on the experience of the department of the Kyiv City Clinical Oncology Center (KCCOC). Materials and methods. A retrospective analysis of the work of the palliative care department of communal non-commercial enterprise “KCCOC” for 2001–2023 was carried out. The center includes a 25-bed hospital and mobile palliative care teams. A multidisciplinary approach was the basis of providing palliative care to an incurable cancer patient. Results. During this period 9,164 cancer patients in the terminal stage with high mortality rate (81.04%) received inpatient care. The average duration of stay in the hospital was 17.7 bed-days. Approximately 6% of patients readmit to the department, some of them – 3-4 times. Approximately 94% of hospitalized patients had a pain syndrome, 86% of patients received opioid analgesia. During this period, mobile palliative care teams registered and served 3,124 cancer patients, among whom 62% of patients were transferred after inpatient treatment, more than 5,700 primary visits were made. The clinical route of the palliative patient was developed and improved, which made it possible to optimize palliative care for a seriously ill oncological patient. The peculiarities of providing palliative care to incurable oncological patients in the conditions of martial law have been determined. Conclusions. Comprehensive palliative care should be a unified system of mobile and stationary care, which will make possible to control the somatic condition of the palliative patient, correct the symptoms of the disease, provide long-term support to the patient at home, which is economically feasible, allows to provide care to a larger number of patients and hospitalize in time if it is necessary. The creation of an extensive system of mobile palliative care is promising in improvement of palliative care for oncology patients (it will reduce the burden on general somatic hospitals and inpatient palliative departments), as well as qualitatively improve the provision of palliative care to patients in the primary care network.