Home-based Pediatric Palliative Care Model Effectiveness in the Developing Countries Context: A Retrospective Analysis - Ukraine Experience

Background: Pediatric palliative care services in the world are provided through two principal models: Institutional and home-based. Integration of those models is also applied.

Aim: To assess the effectiveness of home-based pediatric palliative care model in the developing economy setting of Ukraine.

Design: Retrospective analysis of Ukrainian nation-wide data from pediatric palliative care providers using different pediatric palliative care models was conducted.

Data Sources: Original research data for January 2014 – December 2018 based on the Ukrainian National Scientific Medical Library database records available for four service providers (N=4) (one institutional, two home-based, one integrated model), was analyzed. 7 studies (N=7) were evaluated based on the set of outcomes: morbidity and mortality, health care utilization, patients’ quality of life, cost-and time- effectiveness and continuity of care.

Results: Use of home-based pediatric palliative care model in Ukraine improves health-related and health care utilization outcomes and the patients’ quality of life by wider coverage of families’ psychological/social demands, including home-based death. Under the developing economy conditions, it is more cost-and time-effective than institutional model. Due to Ukraine geographic specifics, it allows wider population coverage and better health services use. To ensure continuity of care, coordination of services between different care providers, defining a detailed scope of the national health insurance coverage for home care services, and rapid transfer protocols elaboration is essential.

Conclusion: Cost-and time-effectiveness of mobile units’ establishment improves health care resources use in lower middle-income country. Home-based pediatric palliative model is an effective way of the development of national pediatric palliative care infrastructure under lower middle income country conditions.