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

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Position of the primary care in the care for
elderly in Slovakia
www.vpl.sk
Peter Liptak, Iveta Vaverkova, Jana Bendova,
Peter PekarovicSlovak Society of General
Practice SkMA EFPC Conference Pisa 31.08.2010
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Slovakia
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Fate of chronic polymorbid elderly patient in
Slovakia
D I A B E T O L Ó G I S T
GERIATRICIAN
P S Y C H I A T R IST
I N F E C T O L ÓG I S T
INTERNIST
A LLERGOLO GI S T
N E U R O L Ó G I S T
PNEUM OLÓGIST
C A R DI O L ÓG I S T
?
...
SPECIALISTS DISPENSARISATION CARE
no power(no competences)
GP - P H C -
Chronic polymorbid elderly patient
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.
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Pims questions...
b ? home visits by GP's, nurses and other health
workers in order to prevent or recognize early
deterioration of the health of elderly people?
The number of GPs 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 isnt 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
operate in the community with limited
competencies, human as well as financial
recouces.
a ? in how far do geriatricians/specialists in
elderly care operate in primary care? Do they
assist/train GP's, do they operate in parallel
to GP's? They operate in parallel to GPs, They
have competences, but they dont 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...
c ? prevention of falls at home (falls are an
important cause of disability and dependence) -
does primary care play a role?Identical with
b)
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Primary care as a hub of coordination?
Private institutions for elderly are
trendy...outside of community, outside of
PHC... expensive ineffective - insufficient
SLOVAKIA Politicians prefer business/market
models in healthcare for elderly...
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This troubleshooting requires a very entusiastic
people
XXXI. Annual conference in Bojnice 21 23
October 2010
We are inviting you...
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Thank you for your attention!