palliative care in accessing and new eu member states daniela mosoiu md. hospice casa sperantei...

Palliative care in accessing and new EU

member statesDaniela Mosoiu MD.

Hospice Casa Sperantei

Romania

22.408.393 INHABITANTS

238.391 KMP

ROMANIA:

Joining EU

• 2004 Czech Republic, Cyprus, Estonia, Hungary, Latvia, Lithuania, Malta, Poland Slovakia, Slovenia

• 2007 Bulgaria, Romania

GDP/capita Int$

• Slovenia 19 600• Czech Republic 16 800• Hungary 14 900• Slovakia 14 500• Estonia 14 300• Lithuania 12 500• Poland 12 000• Latvia 11 500• Bulgaria 8 200• Romania 7 700

The World Fact Book www.cia.gov/cia/publications/factbook/rankorder/2004rank.html

Human Development Index

• Slovenia 0.879 (29)• Cyprus 0.873 (30)• Czech Republic 0.849 (33)• Hungary 0.835 (35)• Slovakia 0.835 (36)• Poland 0.833 (37) • Estonia 0.826 (42)• Lithuania 0.808 (49)• Latvia 0.800 (53)• Bulgaria 0.779 (62)• Romania 0.775 (63)

• UNDP Report 2002

Ratio of palliative care services/million population, (2002) 

• Estonia1: 0.14m Poland1: 0.15m

• Slovenia1: 0.32m Bulgaria1: 0.36m

• Hungary1: 0.37m Latvia1: 0.48m

• Lithuania1: 0.62m Czech R1: 1.02m

• Romania1: 1.07m Slovakia1: 1.33m

Source: Clark D, Wright M (2002) Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central Asia. Buckingham: Open University Press

WHO Recommendations

Education of professionals

• Palliative care recognized as a medical specialty /subspecialty:

Poland

Czeck Republic

Romania

Lithuania

Doctors 650

Nurse and nurse assistants 1560

Social workers 66

Home care assistans 143

Psychologists 21

Pharmacists 136

Volunteers 82

Clerics 6

Fundraisers 10

Managers 8

Students 295

International participants 56

Public awareness

Hungary

2000 public campaign raised awareness with 36%

free TV air time for spots for 2 months

100 billboards across Budapest

Adverts in media

Interviews , charity events

Poland Warsaw-children’s hospice

Funding

• Palliative care free of charge for the patients

• International grants, fundraising in the communities

• Through the Insurance system, government (Poland, Hungary, Lithuania, Romania, Slovenia, Bulgaria)

National Policy

• national committees in the government to address the issue of palliative care

Poland

Slovenia

Lithuania

Hungary

+/-Romania

Conclusion

• Initiatives and models of good practice in all the countries

• Services offered mainly for adult cancer patients, few services for children

• Development of services not directly coordonated with economic indicators

• Low coverage under 5-10% except Poland

• Funding coming mainly from the voluntary sector

I will just once pass through this life. Thus, if I can offer a little kindness, or do good even in a small way to a fellow human being, I promise to do it now, without hesitation, because there will be no second chance. William Penn