OBJECTIVES: to describe the current use of palliative services in Romania, both inpatient care and home care, the reimbursement and coverage in territory in Romania

METHODS: analysis of large administrative database (all cases reported by hospitals 2014-2016, for DRG reimbursement purpose), literature review and critical review of current legislation on the topic

RESULTS: during the studied period, the number of hospital palliative care suppliers increased by 62% (40% of them being privately held). Still the coverage of population with palliative care services varies intensely from a territorial perspective, with a number of counties lacking suppliers of such services having contracts with the respective health insurance fund, while only two counties account for 40% of hospitalization episodes. Patients are hospitalised for a wide range of diseases (cardiovascular, cancer, neurological) but have no actual alternative to continue the healthcare at home. Home care is very limited as reimbursement, only 93 patients have been reimbursed for palliative home care in 2016 while 14.559 inpatients were treated in palliative care wards. Home palliative care also can only be provided for cancer and HIV, according to current legislation.There is a discrepancy between funds allocated by the National Payer to inpatient palliative care versus home palliative care per episode, and also among counties.

CONCLUSIONS: The analysis of using palliative care wards shows a steady increase in the need for such care, a wide range of conditions calling for medical assistance of this type, as well as the necessity of an adequate provision of patient’s care after their discharge from hospital. The healthcare strategy in this domain should be reshaped in order to increase the access of the patients to adequate healthcare.