(Dis)organization of Palliative Care as a Potential Quality-of-Life Issue in the Senior Population – Croatian Experiences
This paper analyses the current situation in the Croatian health-care system, with special emphasis on the (dis)organization of palliative care within the public health, more precisely gerontology context. Namely, population world-wide is getting older, that is both a statistical and an everyday-medical fact. Today we consider citizens after the age of 65 as the elderly, with a tendency to move the age-limit to 75 years. Croatia on the matter swiftly follows global trends, while literature points to the fact that an increase in the elderly population dictates the need for an organized system of palliative care and hospice building. Although we can not ignore the fact that children can become palliative care patients, we can conclude that these are predominantly elderly patients. In fact, aproximately half of patients - users of palliative care - have some type of oncological diagnosis, a significant number of patients suffers from dementia, stroke or heart failure. As for the Primorsko-goranska county and the City of Rijeka, they show similar trend, as can be illustrated with data from the 2011 census, when the share of citizens over 65 years in the population of Primorsko-goranska county reached 18,91%, and in the population of the City of Rijeka 19,74%. Thus, one of the main quality-of-life issues in the Croatian senior population is the (dis)function of the palliative medicine/care system. Practice, namely, shows that there has still been no implementation. In particular, palliative medicine is not yet recognized as a speciality or sub-speciality, standards and norms for this activity are not set, palliative care is still not included in the system of obligatory health insurance, and as far as the national strategy of health policy for the area of palliative care, Croatian Government at its meeting held on 27th December 2013 finally adopted the "Strategic Plan for Palliative Care of the Republic of Croatia for the Period 2014-2016". Exactly because we are a decade behind European standards (Reccommendation Rec (2003) 24 of the Committee of Ministers to member states on the organization of palliative care), it is more than legitimate to place this subject at the centre of the current Croatian gerontology interest.
Croatia, gerontology, palliative medicine/care, REC (2003) 24, Strategic Plan
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