TÜRKİYE'DE PALYATİF BAKIM HİZMETLERİNİN MEVCUT DURUMU

Öz

Palyatif bak›m kanser kontrol programlar›n›n ve kanser tedavisinin vazgeçilmez bir parças›d›r. Maliyet etkin ve do¤rudan yaflam kalitesini ilgilendirir. Pek çok geliflmifl ülkelerde de¤iflik düzeylerde palyatif bak›m modelleri görülebilir. Ülkemizde ise palyatif bak›m hizmetleri uzun y›llarca göz ard› edilmifltir. Bu araflt›rmada, ülkemizdeki palyatif bak›m hizmetlerinin mevcut durumu analiz edilmifl ve olas› nedenler ortaya konulmaya çal›fl›lm›flt›r. ‹l Sa¤l›k Müdürlükleri arac›l›¤› ile toplanan verilere göre, ülkemizde sadece 9 adet palyatif bak›m merkezi vard›r ve bunlar›n büyük bölümü üniversite hastanelerindedir (7/9). 33 ilde hizmet veren toplam 72 adet a¤r› bölümü vard›. Bu merkezlerin 35’i devlet hastanelerinde, 31’i üniversite hastanelerinde ve kalan 6’s› da özel sektör içerisinde hizmet vermektedir. 28 merkez ( %38,9) Ankara ve ‹stanbul’da yerleflik iken 56 merkez Bat› ve Orta Anadolu’da yerleflikti (%77.7). Ülkemizde kifli bafl› morfin kullan›m› da çok düflük seviyelerdedir. Ancak, opioid kullan›m k›s›tl›l›¤› ile beraber mevcut opioid çeflitlili¤i de ne k›s›tl› olup, immediate release morfin preparatlar› ülkemizde bulunmamaktad›r.

Öz

Palliative care is one of the most important part of cancer control programmes and cancer treatments. It is both a cost effective strategy and is directly related with quality of life. Different types of palliative care models can be seen in most of the developed countries. However, palliative care was an ignored issue for many years in our country. In this research, current status of our country with respect to palliative care services are analyzed and possible reaonns fort he current situations are searched. According to the data gathered from the Health Governor of each province, there are only 9 palliative care service across the whole country and a great majority is located in university hospitals (7/9). There were a total of 72 pain centers in different 33 province. Of these 72, 35 were in governmental hospitals, 31 were in university hospitals and the remaining 6 were in the private sector. Among all, 28 centers were located in Ankara and Istanbul (38,9%) and 56 centers were located in the Middle and Western Anatolia (77.7%). Morphine consumption rates per capita was also found to be lower and in addition to this low consumption rates; the current availaibility of different opioid types were also limited such as there is no immediate release morphine preparations stil in our market.