Klaipėdos universitetas

The World Health Organization acknowledges that the health of people in the European region has improved significantly, but not everywhere and not equally for all. It has set a strategic goal to improve the health of all, and reduce health inequalities. In meeting this goal, Lithuania purposefully strives to reduce inequalities in the health condition of individuals attributed to different social groups, and differences in accessibility to health care. The primary focus is on people with disabilities. In compliance with the UN Convention on the Rights of Persons with Disabilities, Lithuania seeks to provide people with disabilities with health-care services and programmes of the same availability, quality and level which are provided or applied to other individuals, free of charge or at a reasonable price. However, research has revealed a great deal of problems in fulfilling this obligation. The present article focuses on physicians’ experience, and aims to understand, from a physician’s perspective, the financial opportunities and barriers that they encounter in rendering health-care services to people with disabilities. A survey involving 107 physicians was carried out in 2019 and 2020. The research results showed that Lithuania is making progress in increasing funding to the health-care system in a targeted way covering a wide range of its domains. Therefore, physicians have plenty of opportunities to refer patients with disabilities to other professionals for consultation without any financial constraints, to prescribe reimbursable medication, to carry out laboratory and radiological tests, to give instructions to caregivers on patient care, and to hospitalise a patient or transfer him/her to another hospital. The situation is somewhat worse with prescribing the most appropriate reimbursable measures and reimbursable rehabilitation treatment, and the worst situation has emerged in the sphere of reimbursable psychological and social assistance, because these services are usually granted a minimum level of funding. The trends established verify that there is a strong need to develop a more effective public health policy in Lithuania, to reform the health-care system, and to invest in improving its quality, so that the country can take more measures to ensure the health of the population and the inclusive equality of people with disabilities in the health-care system.

The spectrum of the links between the quality of life and health has been expanding due to the phenomenon of health acquiring features of a social phenomenon and growing complexity. The research evidenced that health was considered to be one of the most important, and often the most important, dimension of the quality of life. To more comprehensively identify the health-related factors that affected the quality of life in general, the concept of the health-related quality of life has been developed. In our research 1763 children filled KIDSCREEN52 surveys which evidence tendency as follows: even though two thirds of the children did not indicate they had health disorders, only one third of them assessed their health as excellent and very good. This demonstrates that, in the children’s assessment of health, both the absence of a disease or disability and also psychological and social factors are important.

Recently, health-related quality of life has become one of the main underlying assumptions for public health practice, especially for gaining insights into highly complex health problems that are mainly determined by social factors. Children’s health is highly determined by social factors, especially those in the family environment. We follow a newly emerging trend to investigate health-related quality of life within a family-centered social system instead of individualistic approach; therefore, we chose KIDSCREEN52 questionnaire. We consider KIDSCREEN52 questionnaire significant for public health practice.