International concepts and national strategies for the development of palliative and hospice care

Abstract

In press

Background. Palliative care has evolved from predominantly end-of-life services into an element of integrated health care for people with serious health-related suffering. In Ukraine, planning is complicated by demographic change, chronic disease, wartime disruption and heterogeneous health information.

Aim. To synthesize international concepts, methods for estimating and forecasting palliative care needs, and service-integration models, and to determine their implications for Ukraine.

Materials and Methods. This original theoretical study used bibliosemantic and comparative methods and system analysis. PubMed, Scopus and Google Scholar were searched for 2012–2026; earlier landmark sources were included when necessary for key definitions and methods. Official documents of the World Health Organization, European Association for Palliative Care, International Association for Hospice and Palliative Care and Ukrainian health authorities were analyzed. Forty-five sources were selected. System analysis compared data inputs, estimation methods, service models, implementation constraints and monitoring indicators. The study was conducted as part of the second author's dissertation.

Research Ethics. The study was conducted without the involvement of patients or animals and therefore did not require approval by an ethics committee.

Results. Contemporary concepts emphasize early holistic care for serious health-related suffering and integration with primary care and universal health coverage. Needs assessment methods were grouped into mortality/population-based, epidemiological, utilization/registry-based and time-series approaches; medication planning was considered separately because observed opioid consumption reflects both need and access. Recent Ukrainian data show rapid expansion of contracted inpatient and mobile providers, but geographical inequality, wartime damage, fragmented strategic coordination, limited mandatory undergraduate training and low opioid consumption remain important system indicators.

Conclusions. Planning in Ukraine should combine demographic and disease-specific estimates with utilization data and validated time-series methods rather than rely on one indicator. Priorities are interoperable monitoring, equitable territorial access, competency-based education, continuity of care during wartime and legally proportionate use of person-level data.

Keywords: healthcare management, health services needs and demand, universal health coverage, forecasting, health services accessibility.