Palliative and Hospice Care in the Republic of Croatia: An Overview and Personal Experience

Abstract

The development of palliative care in Croatia began in the early 1990s with Prof. Anica Jušić, who helped organize the first Congress on Palliative Care and also founded the Croatian Society for Hospice and Palliative Care. However, the first mobile palliative care teams were formed only in 2008 and the first specialized institution for palliative care in 2013, which was also the year in which the Government formalized the “Strategic Plan for the Development of Palliative Care.”

There are currently 363 designated palliative care beds in 29 different hospitals in Croatia, with only one specialized establishment for palliative care “Hospice Marija Krucifiksa Kozulić” in Rijeka. This establishment hosts 14 beds and employs nurses and physiotherapists, while doctors from the nearby Clinical Hospital Center perform regular visits and patient check-ups. The establishment treats about 250 to 300 patients a year, 90% of whom are cancer patients, while the average time spent in the institution is 17 days. Approximately 10–15% of the patients are discharged, while the rest spend their final days in the Hospice. Since 2016, the Hospice also actively participates in scientific research, and there have been six scientific studies published based on research conducted on their palliative care patients.

Croatia currently has a dozen functioning mobile palliative teams; however, this is dramatically lower than the recognized need of at least 50–55 mobile palliative teams. Both hospital and family practice physicians who treat palliative care patients agree that there is a growing need for more doctors and nurses working in the palliative care field, along with further education in palliative care (especially developing medical residency focused on palliative care), developing medical algorithms, a clear division and definition of responsibilities for all participants in the palliative care setting, and developing a large volunteer base and weekend services for the patients.