PUC Communications.- It is the first palliative care research in Chile that elucidates what would be missing to guarantee access to palliative care in the country. A painful situation for people who have to face deadly diseases or not. «Closing gaps for universal access to Palliative Care in Chile; severe health-related suffering and the cost of expanding the package of care services”is the investigation in which the research team of the Palliative Medicine and Continuing Care Program of the Faculty of Medicineled by the Dr. Pedro Pérez, head of the UC Palliative Medicine Medical Subspecialty program; he professor at the UC School of Government, Eduardo UndurragaNext to the university of miami and the Memorial Sloan Kettering Cancer Center Research Center. The article was published in the The Lancet Regional Health magazine.
The research addresses access to palliative care in the national health system and its costs within the framework of what was developed by the Lancet Commission and a package of health care services, to advance public policy that allow to reduce the gap to treat this serious suffering.
The total number of people who experienced serious health-related suffering and required palliative care in Chile in 2019 -date on which the study was located- was 104,923 (47,059 were cancer patients and 57,864 with non-cancerous conditions)
The total gap in palliative care coverage is close to 61,000 people, that is, 58% of those in need. To this figure we must add 57,864 people without a cancer diagnosis but who need palliative care.
“It is important to consider that the palliative care package of Chile’s Explicit Health Guarantees, includes some, but not all, of the medicines in the Lancet Commission’s Essential Palliative Care Package”, explains Dr. Pedro Pérez. He points out that they are mainly medicines to control pain and for side effects such as nausea, in addition to lacking medicine for non-painful treatments, such as very strong itching, respiratory secretions, anxiety and depression, gastrointestinal symptoms, among others. In addition, the study mentions the lack of equipment and human resources, as well as universal coverage packages for cancer treatments.
The estimated cost of expanding palliative care to those who need it in Chile is 0.5% of the health budget, that is, it is just over US$120 million: US$50 million to include all the elements of the essential palliative care package for cancer patients and $70 million for all people with non-cancerous conditions.
The total cost to make the package universally available is US$185 million per year, which equates to about US$1,750 per patient.
How are these gaps expressed?
Although the investigation determined that in the country there are only 251 units that provide the service and that have specialized teams for thisthese are mainly concentrated in the metropolitan areas of the country (Santiago, Greater Concepción and Greater Valparaíso).
In the same way, this gap is expressed in the type of administration from which they come. 33% belongs to the private sector, while the remaining 67% is operated by the public system.
For example, 64% (136 palliative care services) have a low complexity service (which, in other words, responds to bringing the issue of health closer to the population level, and they do not carry out large interventions in the field of palliative care), while 36% (115 units) are dedicated to highly complex services.
“Achieving universal access to palliative care is urgent and feasible for Chile” – Eduardo Undurraga, UC School of Government professor.
What is reflected in and what is proposed to move forward?
He paper It considers advancing in strategies that improve the efficiency of the system, for example, providing focused care in different types of patients and, in turn, broadening the distribution of medicine in an effective way in those who receive care through the Palliative Care system.
“Achieving universal access to palliative care is urgent and feasible for Chile,” emphasizes Professor Undurraga, “our country is classified as high-income, and Expanding services and coverage to the essential package of palliative care are affordable and critical responses from the health system to guarantee the financial protection of patients with serious health-related suffering”, he explains. According to the research, it is necessary to close large gaps in the coverage of palliative care for patients with non-oncological conditions and the treatment of symptoms that go beyond pain.
