HOSPICE (AND PALLIATIVE CARE NETWORK) IN ITALY AN UNMPREDICTABLE GROWTH

Transcription

1 HOSPICE (AND PALLIATIVE CARE NETWORK) IN ITALY AN UNMPREDICTABLE GROWTH Furio Zucco Past President Italian Society for Palliative Care Past President Italian Federation for Palliative Care Director of Anesthesia, Intensive Care, Palliative Care and Pain Therapy Garbagnate MilaneseHospital Trustee - Milano European Association of Palliative Care Research Network Glasgow, June 2010

2 H.T. G. Salvini PCPMU GARBAGNATE H LHA GARBAGNATE inhab. BOLLATE H RHO H MILANO LHA RHO inhab

3 GARBAGNATE MILANO LOMBARDIA HOSPICE FACILITY in HOSPITAL 250 Pts/year

4 PALLIATIVE CARE HOSPITAL AT HOME PCPM UNIT 24 HOURS A DAY, 365 DAYS 600 Pts/year

5 Italy - 60 million inhabitants - National Health System - 21 Regional Administrations Local Health Authorities new Terminally ill Pts/year oncological non oncological PALLIATIVE CARE NATIONAL PLAN PTS SET 75 % HOME CARE 25 % HOSPICE

6 Italy Patients Assisted in PCN/ Year ? / % are Oncological Pts

7 Società Italiana di Cure Palliative Fondazione Isabella Seràgnoli Fondazione Floriani FERS Foundation ITALIAN HOSPICE NETWORK PROJECT (RETE DEGLI HOSPICE ITALIANI ) European Association of Palliative Care Research Network Glasgow, June

8 Objective The objective of Italian hospice network Project is monitoring all hospices financed by a specific National Fund (Law 39/99) or by resources coming from other Subjects, in particular from the No Profit Organisations (NPO)

9 Partners involved Isabella Seràgnoli Foundation Floriani Foundation; SICP - Italian Society of Palliative Care Scientific Cohordinator Furio Zucco Past President of SICP

10 1 st Publication in 2007 Hospice in Italia. Prima Rilevazione ufficiale (2006)

11 Hospice in Italy Hospice 2nd Book Scientific Cohordinator F.Zucco in Print June n N. di Hospice operativi H o s p i c e s dati reali n. of working Hospices (Real data: June 2009) n. of planned Hospices (2006 Regional previsioni stimate nel 2006 administrations plans) n. of planned Hospices (2009 Regional previsioni aggiornate al 2009 administrations plans) Law n.39/ million Euros only for Hospices Anno Law n.38/ March million EuroS/year for Palliative Care and Pain Therapy 2 different networks

12 Hospice in Italy Hospices working at June Hospices working at April Hospice working on 31 Dec Hospices working ( ) HOSPICES 2010 Mean 11 beds 17 days in Hospice Staying Mean 11 beds 17 days in Hospice Staying Hospice in Italy 2nd Book 2009 Furio Zucco in priint June 2010

13 THE GLASS CAN BE SEEN AS HALF EMPTY OR HALF FULL

14 Fig. 2 Hospice working at June 2009 Regional Administrations N of Hospices n of Beds Beds/ inhabitants. Hospices probably providing palliative care (31 Dec 2010) N of Hospices n. of Beds Beds/ inhabitants. Inhabitants ISTAT 1 Genuary 09 Abruzzo , Basilicata , , Calabria , , Campania , , Emilia-Romagna , , Friuli Venezia Giulia , , Lazio , , Liguria , , Lombardia , , Marche , , Molise , , Piemonte , , Puglia , , Sardegna , , Sicilia , , Toscana , , Trentino Alto Adige , , Umbria , , Valle d'aosta , Veneto , , Italy , ,

15 Law n.38 6 March 2010 Palliative Care and Pain Therapy Published on G.U. n March 2010 Rules to guarantee acces to the Palliative Care Network and Pain Therapy Network

16 Art. 1 Objectives Art.2 Definitions Law 38 9th March 2010 GU 19th March 2010 Art. 3 Ministery of Health and Permanent State and Regional Adinistrations Council Art. 4 Information campaignes Art. 5 Palliative Care Network and Pain Therapy Network Art. 6 From Hospital to Home No pain project

17 Law n March 2010 Art. 7 Pain daily monitoring into the Inpatient Clinical Diary Art. 8 Professional Education in PC and PT Art. 9 Monitoring of the 2 networks development Art. 10 Simplifing procedures for prescribing analgesic drugs (opioids) Art. 11 Report to the Parlament Art. 12 Financial Support

18 Strong lobbing action Italian Society For Palliave Care Members Italian Federation of Charityes Organisations for Palliative Care 63 NPO s affiliated

19 Palliative Care in Italy Critical Aspects - Hospice and Home Care PC Low integration (National Model) - Difficulties in integration between Public, Charities and For Profit Palliative Care providers in Local Palliative Care Network (LPCN) - Low GP s integration in the LPCC Network (even if in continuous improvement)

20 Palliative Care in Italy Critical Aspects - Leak of: - National standards for accreditation of PC Providers, quantitative and qualitative - Omogenous Reimbursement System (NHS Tariffs for Hospice and Home Palliative Care) - National Educational Program (University and Continuous) - National and Regionals Communication plans - Permanent Public Funds for Research in PC

21 Palliative Care in Italy Critical Aspetcts - Very Low strong Opioids prescription and consumption - Very low awareness of Prognosis and end of life situation - Cultural bias - Negative meaning and awareness for palliative - Confusion between Pallitive Care and Pain Therapy

22 THE GLASS CAN BE SEEN AS HALF EMPTY OR HALF FULL

23 THERE IS A LONG WAY

24 VITTORIO VENTAFRIDDA From roots to the future