Palliative Care in Romania and Lithuania- Between the Necessity of Terminal Patient Assistance and the Rigors of Resource Allocation

Abstract

Background: Palliative care, seen as a fundamental human right, gains increasingly more importance worldwide, but the distribution of this kind of facilities is unequal. Aim: In this paper authors compare the palliative care systems of Romania and Lithuania, post-communist countries, characterized by shifting from a state healthcare system to a decentralized one, based on health insurances. Design: We have performed a desk research in Romanian and English languages, analyzing publications referring to this topic in the two countries. Data sources: Vilnius University Database and Google search engine using as keywords, Lithuania(n) palliative care”, respectively „Romania(n) palliative care”, published between 1975 and 2019. Eligibility criteria: articles published between the years mentioned above in English or Romanian languages. Results: In Romania, the palliative care network is better structured, including both hospital care and home care, for adults and children. Still, opioid consumption in Lithuania is higher than in Romania because of a more flexible prescribing legislation. In Romania, palliative care is a recognized as a medical sub-speciality, while in Lithuania no preoccupations exist in this regard. Conclusions: In both countries state budget funds allocation lacks transparency, and funds allocated for palliative care are insufficient. During the last 20 years Romania has undertaken bigger steps in palliative care than Lithuania, especially due to the effort of a few dedicated professionals. Still, the sub-financing of the two systems and the limited number of professionals limit the system efficiency.