1. Zoltan Balogh PhD MSc RN PT Quality Measurement of Long Term Care in Hungary 21st May 2010, London School of Economics - United Kingdom Semmelweis University Faculty of Health Sciences Department of Nursing Science Council of the Hungarian Health Paramedical Professionals

2. WHO, 1997 DEMOGRAPHIC CHANGES IN THE WORLD 1 proportion of the population aged 65 years and over in 1996 2

3. WHO, 1997 DEMOGRAPHIC CHANGES IN THE WORLD 2 proportion of the population aged 65 years and over in 2020 3

4. POPOULATION BY SEX 1890-1941-2008 Hungarian Central Statistical Office 189019412008 MEN WOMEN 4

5. Estimates and projections of the proportion of the population aged 65 years and over in Hungary 1995-2050 László Hablicsek, Pál Péter Tóth, 1999. 5

6. MILESTONES IN THE HISTORY OF LONG TERM CARE Foundation of home nursing and hospice care (1991-95) Foundation of home nursing and hospice care (1991-95) Reducing the number of hospital bed (1995/1996) Reducing the number of hospital bed (1995/1996) Introducing the new concept for home nursing (1995/1996) Introducing the new concept for home nursing (1995/1996) New Health Act (1997) New Health Act (1997) Introducing the Nursing Departments/ Nursing Institutes (1998) Introducing the Nursing Departments/ Nursing Institutes (1998) Introducing Hospice Home Care teams (1999) Introducing Hospice Home Care teams (1999) Minimum human and material resources (2003) Minimum human and material resources (2003) New professional requirement (2009) New professional requirement (2009) New professional standards in home care (2010) New professional standards in home care (2010) 6

7. QUALITY MEASUREMENT OF LTC 1 Clinical audits Clinical audits Professional guidelines and standards Professional guidelines and standards Nursing protocols Nursing protocols 7

8. QUALITY MEASUREMENT OF LTC 2 Clinical audits organised by NPHMOS: Personnel working conditions: Personnel working conditions: Prescribed specialised training Prescribed specialised training Employment contracts Employment contracts Liability insurance Liability insurance Retrospective analysis of nursing documentation Retrospective analysis of nursing documentation Examination of patent’s rights Examination of patent’s rights Material working conditions: Material working conditions: Existence of equipments Existence of equipments 8

9. QUALITY MEASUREMENT OF LTC 3 Professional guidelines and standards by Ministry of Health and Hungarian Scientific College of Nursing Role of GPs and District and Home Nurse Role of GPs and District and Home Nurse Patient’ admissions Patient’ admissions Process of home and palliative care Process of home and palliative care Hungarian Healthcare Service Standards Hungarian Healthcare Service Standards 9

10. QUALITY MEASUREMENT OF LTC 4 Protocols in the field of home care nursing Nursing and rehabilitation of stroke patients Nursing and rehabilitation of stroke patients Nursing and rehabilitation of MS Nursing and rehabilitation of MS Dietotherapy of chronic cardiac failures Dietotherapy of chronic cardiac failures Physiotherapy of hip joint endoprothesis Physiotherapy of hip joint endoprothesis Incontinence management Incontinence management Wound management Wound management 7

11. QUALITY MEASUREMENT OF LTC 5 ISO Standards Activities of management Activities of management Resources management Resources management Process control Process control Measurement, analysis and improvement Measurement, analysis and improvement Ministry of Health published the recommendation of application of the ISO 9001:2000 standards in the home and hospice health care services. 7

12. INTERNATIONAL CONCEPTS 10

13. Thank you for your kind attention! „For health and for the sick with representing our profession” 11

14. REFERNCES Balázs E. Interjú Boldogné Csurik Magdolnával az Országos Tisztiorvosi Hivatal Ápolási Szakfelügyeleti Osztálynak vezetőjével. Otthonápolás. 2005;1(5):5-9. Balázs E. Interjú Boldogné Csurik Magdolnával az Országos Tisztiorvosi Hivatal Ápolási Szakfelügyeleti Osztálynak vezetőjével. Otthonápolás. 2005;1(5):5-9. Balogh Z, Borbas I, Lako E. Nursing in Hungary. Budapest: Institute for Basic and Continuing Education of Health Workers; 2008. Balogh Z, Borbas I, Lako E. Nursing in Hungary. Budapest: Institute for Basic and Continuing Education of Health Workers; 2008. Hajnal MP. Minőségfejlesztés – egy korszak kezdete – tovább egy megkezdett úton. Otthonápolás. 2005;1(5):14-16. Hajnal MP. Minőségfejlesztés – egy korszak kezdete – tovább egy megkezdett úton. Otthonápolás. 2005;1(5):14-16. Hegedűs K. HPPA: the rise of Hungarian hospice and palliative care. European Journal of Palliative Care 2010;17(2):98-100. Hegedűs K. HPPA: the rise of Hungarian hospice and palliative care. European Journal of Palliative Care 2010;17(2):98-100. ICN. Delivering quality, serving communities: Nurses leading chronic care. Geneve, 2010. p. 2-42. ICN. Delivering quality, serving communities: Nurses leading chronic care. Geneve, 2010. p. 2-42. Modly D, Zanotti R, Poletti P, Fitzpatrick JJ. Home Care Nursing Services. In: Balogh Z, Modly D.: Home-Based Health Care in Hungary. (Chapter 12) New York, USA Springer Publishing Company, Inc.; 1997. p. 127-132. Modly D, Zanotti R, Poletti P, Fitzpatrick JJ. Home Care Nursing Services. In: Balogh Z, Modly D.: Home-Based Health Care in Hungary. (Chapter 12) New York, USA Springer Publishing Company, Inc.; 1997. p. 127-132. Richard B, Figueras S & J. Europen Health Care Reform. WHO Regional Office for Europe, Coppenhagen, 1997. p. 22-28. Richard B, Figueras S & J. Europen Health Care Reform. WHO Regional Office for Europe, Coppenhagen, 1997. p. 22-28. Stubnya G, Balogh Z., Csetneki J. Zur beruflichen Situation von Pflegefachkräften und Geburtshelfern in Ungarn. Pflegerecht 2009;9:428-434. Stubnya G, Balogh Z., Csetneki J. Zur beruflichen Situation von Pflegefachkräften und Geburtshelfern in Ungarn. Pflegerecht 2009;9:428-434. 7