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      Hospice and Palliative Medicine in the Republic of Poland, Romania & the Slovak Republic: Policy Implementation, Medical Economics, & Clinical Outcomes

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      Clinical Social Work and Health Intervention

      Journal of Clinical Social Work and Health Intervention

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          Abstract

          Objective: The aim of this research is to compare the current state of hospice and palliative medicine in The Republic of Poland, Romania, and the Slovak Republic. Design: The paper is a secondary source literature review. Results: Hospice and palliative medicine are well integrated into each national healthcare system, but proper funding is needed in order to continue expanding this form of care and reach all patients in need. Conclusion: Since the 1990s, Poland, Romania, and the Slovak Republic have made significant strides in developing hospice and palliative medicine and integrating this care into their national healthcare systems. Opportunities for future development include creating models for funding through the national healthcare systems and expanding home-based palliative care modalities.

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          Most cited references 6

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          Formulary availability and regulatory barriers to accessibility of opioids for cancer pain in Europe: a report from the ESMO/EAPC Opioid Policy Initiative.

          Many patients in Europe do not receive adequate relief of pain because of excessive regulatory restrictions on the availability and accessibility of opioids. This is a major public health problem. The aim of the study is to evaluate and report on opioid availability and the legal and regulatory barriers to accessibility across the countries of Europe. European Society for Medical Oncology and European Association for Palliative Care national representatives reported data regarding survey of opioid availability and accessibility. Formulary adequacy is evaluated relative to the World Health Organization (WHO) essential drugs list and the International Association for Hospice and Palliative Care list of essential medicines for palliative care. Overregulation is evaluated according to the guidelines for assessment of national opioid regulations of the WHO. Data were reported on the availability and accessibility of opioids for the management of cancer pain in 21 Eastern European countries and 20 Western European countries. Results are presented describing the availability and cost of opioids for cancer pain in each surveyed country and nine forms of regulatory restrictions. Using standards derived from the WHO and International Narcotics Control Board, this survey has exposed formulary deficiencies and excessive regulatory barriers that interfere with appropriate patient care in many European countries. There is an ethical and public health imperative to address these issues.
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            Comparison of legislation, regulations and national health strategies for palliative care in seven European countries (Results from the Europall Research Group): a descriptive study

            Background According to EU policy, anyone in need of palliative care should be able to have access to it. It is therefore important to investigate which palliative care topics are subject to legislation and regulations in Europe and how these are implemented in (national) health care plans. This paper aims to deliver a structured overview of the legislation, existing regulations and the different health care policies regarding palliative care in seven European countries. Methods In 2008 an inventory of the organisation of palliative care was developed by the researchers of the Europall project. Included were two open questions about legislation, regulations, and health policy in palliative care. This questionnaire was completed using palliative care experts selected from Belgium, England, France, Germany, the Netherlands, Poland and Spain. Additionally, (grey) literature on palliative care health policy and regulations from the participating countries was collected to complete the inventory. Comparative analysis of country specific information was performed afterwards. Results In all countries palliative care regulations and policies existed (either in laws, royal decrees, or national policies). An explicit right to palliative care was mentioned in the Belgium, French and German law. In addition, access to palliative care was mentioned by all countries, varying from explicit regulations to policy intentions in national plans. Also, all countries had a national policy on palliative care, although sometimes mainly related to national cancer plans. Differences existed in policy regarding palliative care leave, advance directives, national funding, palliative care training, research, opioids and the role of volunteers. Conclusions Although all included European countries have policies on palliative care, countries largely differ in the presence of legislation and regulations on palliative care as well as the included topics. European healthcare policy recommendations should support palliative care access across Europe.
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              Training the workforce: Description of a longitudinal interdisciplinary education and mentoring program in palliative care

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                Author and article information

                Journal
                Clinical Social Work and Health Intervention
                cswhi
                Journal of Clinical Social Work and Health Intervention
                2222386X
                20769741
                July 30 2019
                June 28 2019
                July 30 2019
                June 28 2019
                : 10
                : 2
                : 93-100
                Article
                10.22359/cswhi_10_2_12
                © 2019

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

                Psychology, Social & Behavioral Sciences

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