LAUSR

Palliative care is focused on the relief of serious suffering due to severe illness. The Polish health reimbursement system limits it to a "basket" of recipients with life-limiting incurable diseases (mainly cancer), not responding to disease-modifying therapy. This scoping literature review was aimed at establishing a definition for the criteria of medical referral with regard to "life-limiting illness" and "disease-modifying therapy", which may aid in increasing appropriate treatment and referrals. The PubMed and Google Scholar databases (2011-2021) were searched in the context of referral/eligibility/admission and end-stage/palliative care. Of 790 research articles, 103 studies met the inclusion criteria. Two groups of referral criteria were found: disease/prognosis- and needs-based. The first was concentrated on 6-12-month survival prognosis, the second encompassed the presence of severe/complex/persistent symptoms/problems not responding to optimal treatment. Numerous examples of disease-modifying treatments within specific advanced diseases were found. The discriminants characterizing life-limited diseases in individual cases should be preferably used in clusters to accurately screen for eligibility. Equally important as limited prognosis is the presence of severe, complex, and persistent symptoms or problems occurring despite optimal treatment and general care. Based on the reviewed findings, national reimbursement coverage should be urgently extended to cover more patients who are eligible and could benefit from specialist palliative care. Additionally, general palliative care should be universally acknowledged.