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Implementation of palliative care consult Service in Hungary – integration barriers and facilitators
BMC Palliative Care ( IF 2.5 ) Pub Date : 2020-03-27 , DOI: 10.1186/s12904-020-00541-0
Antal T. Zemplényi , Ágnes Csikós , Marcell Csanádi , Maureen Rutten-van Mölken , Carmen Hernandez , János G. Pitter , Thomas Czypionka , Markus Kraus , Zoltán Kaló

The Palliative Care Consult Service (PCCS) programme was among the first initiations in Hungary to provide palliative care for patients admitted to hospital. The PCCS team provides palliative care for mainly cancer patients and their family members and manages the patient pathway after being discharged from the hospital. The service started in 2014 with 300–400 patient visits per year. The aim of this study is to give a comprehensive overview of the PCCS programme guided by a conceptual framework designed by SELFIE (“Sustainable intEgrated chronic care modeLs for multi-morbidity: delivery, FInancing, and performancE”), a Horizon2020 funded EU project and to identify the facilitators and barriers to its wider implementation. PCCS has been selected by the SELFIE consortium for in-depth evaluation as one of the Hungarian integrated care models for persons with multi-morbidity. The qualitative analysis of the PCCS programme was based on available documents of the care provider and interviews with different stakeholders related to the programme. The integrated, multidisciplinary and patient-centred approach was well-received among the patients, family members and clinical departments, as verified by the increasing number of requests for consultations. As a result of the patient pathway management across providers (e.g. from inpatient care to homecare) a higher level of coordination could be achieved in the continuity of care for seriously-ill patients. The regulatory framework has only partially been established, policies to integrate care across organizations and sectors and adequate financial mechanism to support the enhancement and sustainability of the PCCS are still missing. The service integration of palliative care could be implemented successfully in an academic hospital in Hungary. However, the continuation and enhancement of the programme will require further evidence on the performance of the integrated model of palliative care and a more systematic approach particularly regarding the evaluation, financing and implementation process.

中文翻译:

在匈牙利实施姑息治疗咨询服务-整合障碍和促进者

姑息治疗咨询服务(PCCS)计划是匈牙利首批为住院患者提供姑息治疗的服务。PCCS团队主要为癌症患者及其家人提供姑息治疗,并在出院后管理患者的病程。该服务始于2014年,每年有300-400位患者就诊。这项研究的目的是在SELFIE设计的概念框架(“针对多种疾病的可持续的综合慢性病护理模式:分娩,融资和绩效”),Horizo​​n2020资助的欧盟项目以及确定促进其广泛实施的障碍和障碍。SELFIE财团已选择PCCS作为深入综合评估的匈牙利多病患者模型之一。PCCS计划的定性分析基于护理提供者的可用文件以及与该计划有关的不同利益相关者的访谈。综合,多学科和以患者为中心的方法在患者,家庭成员和临床部门中广受欢迎,这一点已得到越来越多的咨询请求的证实。由于跨提供者的患者路径管理(例如,从住院治疗到家庭护理),可以在重病患者持续护理方面实现更高水平的协调。监管框架只是部分建立,仍然缺乏用于在组织和部门之间整合护理的政策以及用于支持PCCS的增强和可持续性的适当财务机制。可以在匈牙利的一家学术医院成功实施姑息治疗的服务整合。但是,该计划的继续和加强将需要进一步证据证明姑息治疗综合模型的效用,并需要一种更加系统的方法,特别是在评估,筹资和实施过程方面。
更新日期:2020-04-22
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