Changes in the quality of the accessible environment when providing palliative care in 2021–2023

Introduction. Improving palliative care requires a comprehensive assessment of the quality of its provision from the point of view of patients and their immediate environment, including an assessment of the accessible environment for people with disabilities. The Russian Federation is one of the few countries where this task is set and solved at the state level. The purpose of the study: to analyze the dynamics of the subjective assessment of the state of the accessible environment in medical organizations providing palliative care for the period 2021–2013. Materials and methods. The material for the analysis was the results of a sociological survey of palliative care users over 18 years of age; relatives and legal representatives of adult (over 18 years old) patients in need of primary care; relatives and legal representatives of children (under 18 years of age) in need of primary health care, conducted in 2021–2023 using personal interviews at the place of residence. The following methods were used: descriptive statistics and the sociological survey method. Results. In 2023, compared to 2021, the study showed a significant increase in the proportion of respondents among recipients of palliative care over 18 years of age who noted subjective satisfaction with the equipment of medical organizations to receive people with disabilities. In the group of relatives of palliative care recipients over 18 years of age, compared to 2021, there is also a significant increase in the share of respondents noting subjective satisfaction with the equipment of medical organizations for receiving persons with disabilities from 82% in 2021 to 95% in 2023. This suggests that the accessible environment for persons with disabilities in medical institutions is being improved within the framework of ongoing state and regional programs. A survey of parents of children requiring palliative care also shows a steady increase in satisfaction with the accessible environment in medical institutions over the same period from 85% to 90%. A small proportion of respondents (5–10% of all respondents) indicated some shortcomings in medical organizations, mainly related to the lack of handrails, a sufficient number of wheelchairs and accompanying personnel, and the lack of information stands in Braille). Conclusion. A survey of people in need of palliative care and their relatives and legal representatives showed that in general the situation with the modernization of medical organizations in terms of creating an accessible environment for patients with disabilities is steadily improving. The vast majority of respondents say that they are completely satisfied with the state of the accessible environment of medical organizations providing palliative care.