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