International Policy Fellowship
ID 0329 – PBH – LUN - SI
Urska Lunder
Ljubljana, Slovenia
A model for classifying and paying for palliative care in Slovene health care system
The objective of this project is to create a pilot study to test a classifying system and common protocol (clinical pathway) in order to identify optimal model of implementation process for palliative care services into Slovene national health care system.
Present interim report covers activities related to the research undertaken between March and August 2004.
March
1st seminar in Budapest
Re-evaluation of project proposal
Collection of the literature
Studying and collecting data about present situation in palliative care in Slovenia
Publishing articles
Compare Slovenia with selected other countries in terms of data system, payment modes and clinical practice
April
Meeting with the group mentors*
Participating at the International CEE Conference: Effective Advocacy for Health, Bled, Slovenia, April 21-24, 2004
Connecting with experts in palliative care in United Kingdom, United States, Sweden and Spain – Catalonia
Identification of palliative care teams of the pilot study
Starting workshops for education of future palliative care teams: Oncology Institute, Ljubljana, Hospital Golnik, Golnik; first part: professional education
Publishing an article: Lunder U. Medicinsko – socialna skrb za starejše v Sloveniji (Socio-medical care for the elderly in Slovenia). Zdravstveni Vestnik, (will be published in August 2004).
May
Review clinical protocols in palliative care
Make decision about the choice of the clinical protocol, refine it as necessary
Explore classification models
Workshops for palliative care teams; first part: professional education
Preparing a paragraph with a title: National standards in hospice and palliative care, for a book from Michael Wright and David Clark (editors): Culture, ethics and policy: reflections on hospice and end of life care in Eastern Europe and Central Asia, Lancaster University, United Kingdom.
Presentation of the pilot study to the National Health Board at the Ministry of Health, Slovenia
Decisions regarding changes to routine palliative care data set for better clinical management
Workshops for palliative care teams; first part: professional education
Active participation on the Conference: Research Forum of European Association for Palliative Care, Stresa, Italy, June 3-5, 2004: Oral presentation of an original article: Palliative care standards - how to achieve effective implementation into practice
Invitation from editor for an editorial published in the Journal Palliative Medicine:
Lunder U, Sauter S, Furst CJ. Evidence based palliative care – beliefs and evidence for changing practice. Palliat Med 2004, 18:265 – 266.
Preparing a paragraph in a book: Zdravje za poznejša leta (Health for later years), published by Cardiology Association Slovenia
Establishing co-operation with Catalonia – initiating procedure of formal co-operation between Slovenian and Catalan Ministry of Health in the field of palliative care (letter of intent from Slovene minister Prof. dr. Dusan Keber to Catalan minister dr. Marina Geli)
July
Preparation and planning of study visit to Barcelona, Spain in August:
Unit in a Cancer Comprehensive Center (Institut Catalŕ d’Oncologia),
Support team in a Teaching Hospital (Badalona or Vall d’Hebrón),
Units and networks in Socio-health centers (Sta Creu de Vic),
Unit in nursing home (Sta sussagna de Caldes),
Home care support teams,
Meeting experts on payment systems at the Servei Catalŕ de la Salut
(Financing agency)
Meeting with responsibles of international aspects at the Ministry of Health
Several meetings (discussion- proposals) with Dr. Xavier Gómez-Batiste
Establishing a formal co-ordination body at Ministry of Health for co-operation of different experts in the field in the process of development of the pilot project
Modification of chosen clinical pathway, preparation of the documentation.
Developing the Research Paper – 1st draft version.
* During the first meeting with group mentors in April the initial project proposal has been re-evaluated. The major changes to the initial project proposal have been the following:
More preparations to the pilot testing of the model, timetable for starting the use of clinical pathways starts in September 2004.
Connecting with experts or a country of successful implementation of palliative care payment system in order to start further co-operation and receive a support.