The number of Ukrainian pediatric patients is increasing and the number of pediatric patients is decreasing. “We are looking for reserves, but we need help in many localities,” explains Ilona Hülle, president of the Association of General Practitioners for Children and Adolescents.

About half of Ukrainian refugees are children. Their numbers continue to grow, but the current capacity of GP surgeries for children and adolescents (PLDD) is not ready for them. The problem lies above all in the localities where there is a shortage of these doctors and where there are also a greater number of Ukrainian children. The so-called UA Points, introduced recently, are a welcome help in university hospitals by order of the Ministry of Health. “The establishment of such detention centers can help to manage the situation, but a longer-term solution will have to be sought”, says the president of the Association of General Practitioners for Children and Adolescents of the Czech Republic (SPLDD) MUDr. Ilona Hulleova.

“We raised the issue of the shortage of these doctors with the health insurance funds, which are responsible for ensuring the availability of care, and also with the Ministry of Health even before the start of the covid pandemic”, says the president.

He draws attention to the existence of localities in the Czech Republic, where after the departure of general practitioners, most often in retirement, hundreds and thousands of children remain, struggling to find a new approved general practitioner. “We are trying to solve the situation by looking for reserves, which are getting smaller every year. Following the outbreak of war in Ukraine, we called on all PLDD to provide acute care to all children, regardless of their status or their health insurance,” said the president.

Help from pediatricians in hospitals is needed

Doctors take this for granted and most of them have placed some children in long-term care. They developed guidelines on how to take care of children, and the doctor’s office received information about the epidemiological situation in Ukraine, a valid vaccination schedule for Ukrainian children and a dictionary to remove the language barrier. The terms of reimbursement for care provided were also negotiated. “However, with the increasing number of children, it turns out that we need help in many localities, especially from hospital paediatricians,” said Hülle.

University hospitals have been replacing this care since the beginning of last week, directly on the basis of methodological instructions from the Ministry of Health. For example, at the Bulovka University Hospital, two “detention centers” were opened, one of them in the children’s pediatric department. “One of the UA points has been opened for Ukrainian children who do not have a pediatrician here and who come because of a preventive examination, vaccination or an acute problem. Their anamnesis is entered into the system and then, depending on the specification of the difficulties, they are sent to a children’s outpatient clinic or a specialized workplace,” says hospital spokeswoman Eva Libigerová.

In the same form, health care is provided to children at the Motol University Hospital. “UA Point is divided into a section for children and a section for adults. It replaces primary care, i.e. practices. It is a place where people go with common health problems, with whom they go to a general practitioner”, explains Olga Merxbauerová, a representative of the communication department. The UA points operate in both establishments from 7 a.m. to 3 p.m., outside opening hours, they also operate within the framework of a emergency reception.

short term solution

In the Bulovka University Hospital, this position is occupied by a technical-economic worker and a nurse, and an interpreter is also available. In the short term, the creation of UA points, according to a hospital spokesperson, could alleviate the system, in which pediatricians in the field are now heavily burdened with newly arrived pediatric patients, “however, in the long term, their staffing will need to be strengthened,” he said.

He agrees with SPLDD chairwoman Ilona Hülle in this regard. “We welcome the creation of UA points, which should help provide acute care in places where there are not enough general pediatricians,” said the president. According to her, this is constantly changing and depends on many factors. For example, if child morbidity increases, including new cases of covid, the capacity of medical practices is often overwhelmed. Then there is no time to treat other patients. At the same time, he must also provide children with a number of preventive examinations to which children are entitled, including vaccinations. “That is why the help of UA points is welcome from our side. The establishment of such detention centers can help to manage the situation, but a longer-term solution will have to be sought,” concludes Hülle.

Silvie Purmova

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