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Palliative care in accessing and new EU member states Daniela Mosoiu MD. Hospice Casa Sperantei Romania ROMANIA: 22.408.393 INHABITANTS 238.391 KMP Joining EU • 2004 Czech Republic, Cyprus, Estonia, Hungary, Latvia, Lithuania, Malta, Poland Slovakia, Slovenia • 2007 Bulgaria, Romania GDP/capita Int$ • • • • • • • • • • Slovenia Czech Republic Hungary Slovakia Estonia Lithuania Poland Latvia Bulgaria Romania 19 600 16 800 14 900 14 500 14 300 12 500 12 000 11 500 8 200 7 700 The World Fact Book www.cia.gov/cia/publications/factbook/rankorder/20 04rank.html Human Development Index • • • • • • • • • • • Slovenia Cyprus Czech Republic Hungary Slovakia Poland Estonia Lithuania Latvia Bulgaria Romania 0.879 (29) 0.873 (30) 0.849 (33) 0.835 (35) 0.835 (36) 0.833 (37) 0.826 (42) 0.808 (49) 0.800 (53) 0.779 (62) 0.775 (63) • UNDP Report 2002 Ratio of palliative care services/million population, (2002) • • • • • Estonia1: 0.14m Slovenia1: 0.32m Hungary1: 0.37m Lithuania1: 0.62m Romania1: 1.07m Poland1: 0.15m Bulgaria1: 0.36m Latvia1: 0.48m Czech R1: 1.02m Slovakia1: 1.33m Source: Clark D, Wright M (2002) Transitions in End of Life Care: Hospice and Related Developments in Eastern Europe and Central 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