Accessibility and challenges of perinatal palliative care in Poland

Urszula Tataj-Puzyna, Beata Szlendak, Izabela Kaptacz, Dorota Sys, Maria Węgrzynowska, Barbara Baranowska
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Abstract

Introduction: This article examines the legal status and level of accessibility to perinatal palliative care (PPC) in Poland, with a focus on the number of services provided and the number of parents receiving PPC services. Material and methods: The desk research was based on information obtained from the National Health Fund regarding the number of units that signed a contract for the provision of guaranteed PPC services from 2018 to the first half (January–June) of 2022; the number of parents receiving the service from 2018 to 2022; and the number of services provided by a doctor, a psychologist and by primary care midwives (PCMs). In addition, the Map of Health Needs and National Transformation Plan data were used to prepare the data. Results: In Poland, since 2018, PPC services have been provided with public funds under contracts signed with the National Health Fund. Since 2022, these type of services has been provided by 17 centres. Care was provided to 1,860 pregnant women diagnosed with lethal foetal anomaly and to four fathers. There are still voivodeships in which there is a lack of provision of PPC services that are financed from the state budget. Conclusions: In Poland, there is no full accessibility to publicly funded PPC in every voivodeship. The lack of a sufficient number of PPC centres and the lack of a uniform national standard of practice for this type of care — provided in hospices, hospitals and home settings — prevents women from having continuity of professional perinatal care. There is a need to ensure the quality of the services provided and make progress towards the employment of midwives in PPC facilities by service providers to ensure that women receive obstetric care from the moment of an adverse diagnosis, professional preparation for childbirth and the postnatal period.
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波兰围产期姑息治疗的可及性和挑战
前言:本文考察了波兰围产期姑息治疗(PPC)的法律地位和可及性水平,重点关注提供的服务数量和接受PPC服务的父母数量。材料和方法:桌面研究基于从国家卫生基金获得的关于2018年至2022年上半年(1月至6月)签署提供有保证的PPC服务合同的单位数量的信息;2018年至2022年接受该服务的家长人数;以及医生、心理学家和初级保健助产士提供的服务数量。此外,还利用卫生需求图和国家转型计划的数据编制了这些数据。结果:在波兰,自2018年以来,根据与国家卫生基金签署的合同,PPC服务由公共资金提供。自2022年以来,17个中心提供了这类服务。向1 860名诊断为致命胎儿畸形的孕妇和4名父亲提供了护理。仍有一些省缺乏由国家预算资助的PPC服务。结论:在波兰,并非每个省都能完全获得公共资助的PPC。由于缺乏足够数量的PPC中心,以及在收容所、医院和家庭环境中提供的这类护理缺乏统一的国家实践标准,妇女无法获得持续的专业围产期护理。有必要确保所提供服务的质量,并在服务提供者在PPC设施中雇用助产士方面取得进展,以确保妇女从不利诊断的那一刻起,从分娩的专业准备到产后,都能得到产科护理。
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来源期刊
Palliative Medicine in Practice
Palliative Medicine in Practice Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
15
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