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History and Development of Palliative Care
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Current services in Croatia
The following palliative care services are known to exist in Croatia:
  Existing Services (2002)
Adult Inpatient - Freestanding 0
                - Hospital Unit 0
                - Hospital mobile team 0
Nursing Home 0
Home Care 1
Day Care 0
Total 1
Paediatric Inpatient 0
Home Care 0
Day Care 0
Unspecified 0
Total 0
Grand Total 1
Current Projects
The following palliative care projects are known to exist in Croatia; these are not yet operational services:
  Known hospice/ palliative care projects (2002)
Adult Inpatient - Hospital 0
                - Hospice 0
Home Care 0
Unspecified 7
Total 7
Paediatric Hospital 0
Hospice 0
Home Care 0
Unspecified 0
Total 0
Grand Total 7
The only current palliative care service in Croatia is a hospice home care team based in Zagreb and run by members of the Croatian Society for Hospice/Palliative Care. Soon to move to its own premises in a health care home in the east of the city, it will then also establish a day care service. Volunteer doctors, nurses and social workers make up the home care team, working evenings, weekends and in holiday time. This service began in January 2000. During its first year, with the services of a total of 18 volunteers, 771 visits were made to 57 patients; visits lasted between 1-4 hours and were sometimes overnight. Help was also given through a substantial number of telephone consultations with doctors (1,000) and nurses (691). The service holds a stock of special beds, portable toilets and other aids and equipment. The group also provides a visiting service to patients in a local nursing home. It has not yet received any financial support from the state or from the HZZO (the Croatian insurance fund).
There are examples of other, less developed, groups with palliative care interests in Karlovac, Virovitica, Varazdin, Kopvrinica, Osijek, Split and Pula.
In the Neavy Hospital, Varna, the chief nurse has a special interest in palliative care and is responsible for the independent NGO, Queen Eleonora's Hospice, which provides homecare in Varna. There is a team of 20 nurses and other staff, and the majority of patients have cerebrovascular disease and heart disease. The hospice is seeking to establish an inpatient facility of 15 beds. There is also a group of physicians with plans to open a pain service at the hospital in Varna, but without available funds.
Development project
In Koprivnica Kizevci County, Croatia, which has 326 deaths per year from cancer, 65% of which occur at home, there is a primary health care development project funded by the World Bank and directed by the BIS Health Care Group. Most unusually, the project has produced a needs assessment for palliative care in the county2 and made recommendations for local palliative care service provision.

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