Position of the primary care Position of the primary care in the care for elderly in Slovakiain the care for elderly in Slovakia

Peter Liptak, Peter Liptak, Iveta VaverkovaIveta Vaverkova, Jana Bendova, Peter Pekarovic, Jana Bendova, Peter Pekarovic

Slovak Society of General Practice SkMA Slovak Society of General Practice SkMA

EFPC Conference Pisa 31.08.2010EFPC Conference Pisa 31.08.2010

www.vpl.skwww.vpl.sk

SlovakiaSlovakia

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Fate of chronic polymorbid elderly patient in SlovakiaFate of chronic polymorbid elderly patient in Slovakia

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Chronic polymorbid elderly patient Chronic polymorbid elderly patient

SPECIALISTS – DISPENSARISATION CARE SPECIALISTS – DISPENSARISATION CARE

This patient is early exhausted. In the best case he ends up in a good private institution for elderly - outside of community. Too expensive and inefficient care. Insufficient public health care.

☻ no powerno power(no competences)(no competences)

a ? in how far do geriatricians/specialists ? in how far do geriatricians/specialists in elderly care operate in primary care? in elderly care operate in primary care? Do they assist/train GP's, do theyDo they assist/train GP's, do they operate in parallel to GP's? operate in parallel to GP's?

They operate in parallel to GPs, They have competences, but they don´t operate in community in primary care.

There is a meaningful coordination with GPs missing

Coordination is assured via transportingpatients to geriatricians/specialists offices with ambulances or otherwise. Often, this process employs the whole family...

b ? home visits by GP's, nurses and other health ? home visits by GP's, nurses and other health workers in order to prevent or recognize early workers in order to prevent or recognize early deterioration of the health of elderly people? deterioration of the health of elderly people?

The number of GP´s home visits is reduced. Home visits are not supported by payments from insurance companies neither by policy of health care system. GP without competences in his office isn´t motivated to provide homecare.

Nurses do the home visits rarely. In the past - one GP used to have 2 nurses – one for home visits. This system is not supported anymore.

Independent home nursing care agencies operatein the community with limited competencies, human as well as financial recouces.

c ? prevention of falls at home (falls are an ? prevention of falls at home (falls are an important cause of disability and dependence) important cause of disability and dependence) - does primary care play a role?- does primary care play a role?

Identical with b)

Pim´s questions...

Primary care as a hub of coordination?Private institutions for elderly are trendy...Private institutions for elderly are trendy...outside of community, outside of PHC...outside of community, outside of PHC...expensive – ineffective - insufficient expensive – ineffective - insufficient

SLOVAKIASLOVAKIA Politicians prefer business/market models in healthcare for elderly... Politicians prefer business/market models in healthcare for elderly...

XXXI. Annual conference in Bojnice 21 – 23 October 2010XXXI. Annual conference in Bojnice 21 – 23 October 2010We are inviting you...We are inviting you...

This troubleshooting requires a very entusiastic peopleThis troubleshooting requires a very entusiastic people

Thank you for your attention!Thank you for your attention!