Lifelong Learning Programme

This project has been funded with support from the European Commission.
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National Reports

The reports describe the situation of health assistance in hospital and at home for patients with chronic deseases in the six countries participating in the project.


The main aims of the reports are:

  • To introduce the Health National System
  • To understand the main national trends as far as the homecare assistance in hospital and at home is concerned
  • To identify the National bodies in charge of the home health service
  • To describe the Strategies and initiatives developed at national and local level to promote and improve the home health service
  • To describe the Training Courses for professional health carers on the issue
  • To Identify best practices in the field

The following National Reports are available (both in English and the National Language) below:



Italian National Report
In Italy, the healthcare system organisation was born in the Middle Ages, when the first hospital for patients and beggars was built. The actual National Health System was born in 1978 with the Law n. 833, to safeguard the physical and psychic health of people as a fundamental right for person and community. The next changes of law and the Constitutional Chart implemented the devolution process and, now, the Italian Regions have the power to make law in the health context. This report describes the main aspects about the story of our NHS, the integration of home care, the hospital and territorial continuity and the social system. A particular focus is dedicated to human resources and professional training pathways on the health promotion, which are very important for the Italian NHS.
Spanish National Report
In the following lines there are described the main guidelines of the home health care attention provided in the health system of Spain. It is very relevant to understand that in Spain very few data in this area is available as consequence of the way that the characteristics of the system. That means that overall information is not generally available but locally and even there is very difficult to know it. The system implies 17 subsystems with general guidelines provided by the government of Spain.
Lithuanian National Report
Lithuania’s health care system is designed according to the basic principles common to European cultures. It is set by the mixed health care financing and organisation system consisting of statutory compulsory health insurance, budget allocations and direct payments of patients. The system provides personal health care, public health and pharmaceutical activities for the whole population by the means described in the Law on the Health Care System.(1) Universal access to basic medical services is granted to the whole population and has been mostly financed according to a solidarity-based scheme of statutory health insurance since 1997. It provides the possibility for the insured to receive individual health care services financed by the State Health Insurance Fund (SHIF) budget, namely, primary outpatient,specialised outpatient, and inpatient health care, first aid and emergencies, nursing care,palliative treatment, expensive tests and procedures, medical rehabilitation, spa treatment, and other services.What concerns home health care institutions and social families in future they will be obliged to receive licences which will be granted in case the social care is provided in comply with social care standards.
Polish National Report
The healthcare system in Poland is based on a system of insurance. It makes it widely accessible, but it also poses difficulties in ensuring adequate funding. The report presents the basics of healthcare organization in Poland, the detailed legislation regulating this issue and describes the main entities constituting the system. It describes also the authorities responsible for shaping the healthcare system, both at national and local level. Particular attention is given to the home health service, and especially its implementation on two areas - primary care and palliative - hospice care. The report presents the organization of these two branches of the healthcare system, an analysis of the medical staff, access to treatment and a system of training specialists in these fields. A comparison was made for access to medical treatment in Poland and the European Union using data on the number of active medical staff. The report presents data separately for doctors, nurses and midwives involved in home healthcare, which allowed to make individual analysis for each of these groups. It also describes Poland's health policy and its implementation with a view to improving the health situation in Poland and the strategies implemented at the local level. It also identifies examples of good practices as models for the implementation of the system.
Romanian National Report
The National Health System in Romania is in a transformation process, because it has not longer met the needs of the population, the vast majority of them considering it inefficient and poorly managed according to a survey done by IRIS Network International. Thus, in 2012 a new law of the health system that meets the needs of the population is going to be released. Home care services occurred in Romania after 1990, but only at the initiative of the NGOs based on external funding. The state became involved much later in this issue in 2000, supporting Act 17 on elderly care. The beneficiaries of home health care are: people with acute and / or chronic diseases, people who have a certain level of dependence and a limited ability to travel to a medical unit. Providers of home health care can be independent people or organisations/companies authorised by the Ministry of Health to provide such services. Providing medical care and patient care at home is done in accordance with the professional training of providers of these services. Home Care in Romania can be provided to: patients with oncologic affections, paralyzed and immobilized in bed, elderly with chronic affections or those in need after a surgical intervention, people with disabilities, chronic diseases, children with special needs, victims of domestic violence have the right to public insurances paid homecare. The private foundations have had a great contribution to the development of home care services, which are only partially funded by state, the remaining funding being obtained from private funds.
Slovak National Report
Health care system in Slovakia has long history. Following the velvet revolution in 1989 transformation process has started. The decentralization and the transfer of state monopoly to regional levels with the option of various providers of social and health care emerged. The special medical treatment for elderly people or people with disabilities or those who are in need of long-term care is separated from social treatment (selfservice, allimentation, homemade activities, transportation and social counselling), while the former belongs under administration of Ministry of Health and latter of Ministry of Labor Social Affairs and Family. This segregation is administratively demanding for providers. Increasing ageing of population calls for new approaches how to satisfy the demand for increased need of care. At present 66% of all capacities in institutional care belongs to elderly and the rest to people with disabilities or chronically ill. Still 18 000 elderly people are on the waiting list to retirement houses or houses of social services. The development of home care with more complex services was challenge from nineties and each year new agencies are established into operation. The staff of agencies besides nursing has also educational role to teach family members how to treat the patient. These agencies grow in numbers each year and play important role in nursing care. Several types of providers both from the social domain and also from the health care are described with the division to social and health care institutions and home care and health care agencies.