A comparative study on the palliative care in Romania and France

Abstract

The palliative care has old tradition, as the single support and relief of suffering in terminally ill patients form, until the release of antibiotics and the development o f modern medical technologies, investigation, diagnosis and treatment. In the 1960s the palliative care was officially recognised as a medical field, focused on the psycho-emotional and spiritual aspects without neglecting, however, the physical aspects o f care. Further evolution differed on a country basis. The health insurance systems in Romania and France are based on the same principle o f solidarity. The history o f the two palliative care systems has close start. In this context, we propose a comparative study to identify the differences and similarities between the systems o f palliative care in the two countries. Certain evaluation criteria were selected for this purpose, in order to ensure a complex approach for this type o f service. We have used the methods o f study documentation and direct observation through an internship performed in a clinic in France, Groupe Hospitalier Saint Augustine-Malestroit. In spite of the chronic low funding of the health system, non-challenging and lean health legislation, the system of palliative care has developed slowly, hut progressively, in Romania. Though, the level of services is far below the needs. This is imposing a rigorous analysis o f the factors affecting the quality o f life o f patients and the development of services strongly dependention these. The French health care system is an example of good practice regarding availability of health care, health care related services, accessibility to the patient, and the legal frame: national policies, legislation, financial planning models and quality control, training and human resources, including the emotional and spiritual support like patient special needs, family support, support for' pediatric patients and their families, religious and psychological assistance, staff issues.