Current Status of Palliative Care Development in Georgia in comparison with benchmarking countries

Abstract

Introduction: The appropriateness of Palliative Care development can be assessed by comparative benchmarking of some relevant indicators on the issue. Recently published, the EAPC Atlas of Palliative Care in Europe 2019 permits the possibility of benchmarking Georgia’s current status against other European countries as well as against itself based on the previous ATLAS (2013).

Objectives: To describe the country´s situation with regard to that of 2013 and to identify areas of improvement based on benchmarking countries´ data.

Methods: Secondary comparative analysis of data collected in the EAPC Atlas 2013 and 2019. We reviewed the total number of specialized Palliative Care services, the existence of National Palliative Care policies (Strategies and laws), the recognition of Palliative Medicine as a specialization, the extent to which medical schools teach Palliative Medicine to future physicians, and the consumption of pain medicines. All these data were compared with previous Atlas 2013, and with four benchmarking countries: two surrounding ones (Armenia and Azerbaijan), and two referent states from Eastern Europe (Hungary and Poland).

Results: Georgia has a total of 26 specialized PC services for adults (0.6 per 100,000 inhabitants) and five for children. Political will seems inexistent as the National Strategy was not renewed in 2016 and there is not any specific law governing Palliative Care. Although there is a designated person in the Ministry of Health with political/technical responsibility for Palliative Care, dedication is yet unknown. Integration of the palliative medicine into undergraduate education has been established in eight out of 13 medical schools. Low consumption of pain medicines still is one of the main obstacles to good Palliative Care. Compared with 2013 indicators generally show a timid improvement. Georgia reports more services and greater education than surrounding states, but remains far away from other Eastern European countries like Poland, where a wider provision of services, appropriate policies, number of accredited Palliative Care professionals and use of pain medicines are reported. 

Conclusion: Georgia has lately improved and ranks better than neighboring countries. However, coverage is still insufficient for the detected needs. These data support a need to focus on developing accessibility to medicines, on setting specialized services, and on advancing policies to draw near Poland.