IMPLEMENTATION OF HOSPICE – PALLIATIVE CARE IN

HUNGARY

Hungarian Hospice FoundationDr. Katalin Muszbek

Attitude to palliative care in the 80s

Cancer is equal with death and dying

80C% of people with advanced cancer died in hospitals in very poor conditions

Palliative care, pain and symptom control was not acknowledged

Attitude to palliative care in the 80s

Education of medical personnel was based on active treatments

Psychologıcal and spiritual aspects. communication skills, breaking bad news was not include into medical curriculum

Death and dying belonged to the taboos

SUFFERING PATIENTS…

Patients mainly die in hospitals

lonely depressed suffering of pain

and other symptoms

Palliative care should be adapted for quality end of life are in Hungary

Implementation of Palliative care in Hungary

Elements:1. Clinical activities: home care services

and palliative inpatient units2. Training programs for professionals

and volunteers3. Public education for changing public

beliefs to death and dying

Palliative care activities

- Home care- Palliative Inpatient unit- Day centre- Pain clinic- Palliative mobile team- Hospice House- Bereavement support group

SERVICE DEVELOPMENT IN HUNGARY 2008

49 organisations

12 inpatient unit (176 beds) 30 home care team 4 nursing home (34 beds) 2 day care centers 4 palliative care support team

Resource: Hungarian Hospice Palliative Association

HOSPICE-PALLIATIVE CARE IN HUNGARY IN 2008

No. of patients

in 2008: 4 527

in total: 30 468

Average time of care : inpatient: 28,6 days

home care: 48,4 days

Resource: Hungarian Hospice Palliative Association

HOSPICE-PALLIATIVE CARE IN HUNGARY IN 2008

Resource: Hungarian Hospice Palliative Association

Number of hospice professionals in Hungary

1995 2008

Physician 22 103

Nurse 74 509

Physiotherapist 8 73

Psychosocial professionals 10 53

Volunteers 28 133

Chaplain 6 35

Social worker 7 43

Dietetitian 5 40

Coordinator 11 46

Social therapist 2 9

Bereavement counsellor 0 14

DAY CENTRE

BEREAVEMENT SUPPORT GROUP

2. Education programs on palliative care

- Basic courses – 40 hours- Advanced courses for nurses– 40

hours- Courses for physicians- Courses for the members of

interdisciplinary team ( psychologists, social workers, physiotherapists)

BUT – lack of graduate and poor postgraduate education of physicians

2. Education programs on palliative care

Budapest Hospice House is an International Training and Resource Centre supported by OSI

- International courses for EasternEuropean and FSU countries

- 40 hours training courses- Conferences and Seminars

10th EAPC Conference, Budapest June 7 – 9, 2007

10th EAPC Congress Budapest

- 67 countries from all over the world- 2004 participants

3. Publicity campaign on hospice

Aims To promote the integration of

hospice-palliative care into national health service

To raise awareness of hospice-palliative care

To draw the attention of policy makers on suffering, dying patients

Elements of the campaigne

- 3 TV Spots were produced with famous artists

- 3 monthes were showen day by day 5 – 10 times in different TV channels

- Air time was given free of charge

Testimony

Kata Dobó Actress Movie Star Famous

model

Testimony

JUDIT HERNÁDI one of the

most popular actress

TV Star

Testimony

IVÁN MARKÓ

Ballet-dancer, choreographer famous

world-wide Bejart Ballet

Publicity campaign

Elements

Adverts in printed and online media 100 billboards across Budapest Indoor adverts Press conference Interviews about our activities

BILLBOARD

INDOOR POSTERS

Publicity campaign

Results (1)

Changes in awarenessof lay people

from 0% to 36 %

of professionalsgrowing demand for collaboration

More than 100 media publication in written and electronic media.

The campaign has drawn the attention on suffering people

Results

May 2002 opening of the BUDAPEST HOSPICE

HOUSE

Where is Hungary now?Increased number of PC services (2x since 2004)

Legal development: 2004

- Minimum standards of palliative care- Ministry of Health decree on finance

Finance: following the two year financial demonstration project for palliative care the health budget opened for new capacities in 2009

National development plan 2007-2013: integraton of Palliative Care into the National Health System

Palliative care and psychosocial care became an integrated part of National Cancer Control Program in 2006

Thank you for the attention!