Centro Poliklinika, Vilnius
Restricted palliative care
The law that regulates palliative care in Lithuania indicates that a patient is eligible for palliative care only when illness meets certain ICD‘s listed in the law. Also, it is stated that palliative care can be provided only when patients’ condition fits additional terms which indicate the progression of illness. Patients receiving curative treatment cannot acquire end of life care.
This research examines data demonstrating the impact of the Lithuanian palliative care law to people with life threatening illness. We also included policy documents that specify restrictions for patients in order to receive early palliative care. To evaluate the actual need of palliative care in Lithuanian population we counted deaths from chronic terminal illnesses and compared with the number of patients who actually received palliative service in homecare department. In addition, we calculated average duration of provided palliative care services.
The analysis showed that many patients get palliative care just days or hours before death, average duration from the start of services until the death of patient being 14 days. And only 28,6 % of people with life-threatening diseases receive relevant help due to requirements for palliative care. During the research it was also discovered that mandatory bureaucracy delays patient introduction to palliative care team for 5 working days, moreover a Physicians’ Consultative Committee meeting has to take place to establish patients’ eligibility for palliative care.
This study demonstrates that many people in Lithuania living with a life-threatening illness due to palliative care law regulations, either do not receive any palliative care service or receive services only in the last phase of their life. Additional terms are not only diminishing the role of palliative care, but it also becomes a barrier for most of the patients in need and prolongs waiting times. It is notable that only few health care providers deliver palliative care services.