Background: As a consequence of the Aging society, the elderly people have growing
need for long-term care and often for special nursing in addition to the health care
system. The focus of Hungarian health care system lacks basically the examination
of health care provisions carried out in the social care system. The main objective
of this study is to assess the health care needs within the residential social care
institutions for elderly people and to follow the implemented capacity transfer from
hospitals nursing wards to social care residential homes.Approach: In 2015 March-May
time period - with the support of the State Secretary of Social Affairs of the Ministry
of Human Capacities (MHC) about 600 elderly people an empirical survey has been carried
out using institutional and individual datasheets focused on care problems and health
care activities. Data have been analysed by descriptive and regression statistical
methods. Qualitative analysis was carried out making 6 + 4 interviews with directors
of residential care homes and public administrators before (2015) and after (2024)
the implementation capacity transfer from healthcare to social care. Results: The
results showed that the average age of inhabitants of residential social care institutions
became increasingly higher (78 years). Among residents gradually growing rate of dementia
(21.2%), need for intensive care (at least 12 hours a day), or continuous (24-hour)
monitoring and wide range of special nursing activities (in the sample up to 35%)
were observed. Based on this health needs assessment (HNA) our research and administrative
group had developed an integrated organizational care model that later MHC approved
as a comprehensive regulatory background on newly established skilled nursing facilities
(by amendments of social care act, and ministerial order on minimum requirements of
residential homes). Our research and developing expert work continued with the detailed
analysis and obsevation of the current capacity transfers including 2400 beds in 2023-2024
from nursing wards of hospitals to skilled nursing facilities of residential homes
summarising the advantages and futher challenges of these organizational changes.Implications:
The Hungarian integrated skilled nursing program was really based on a HNA, which
was followed by a comprehensive regulatory background, which can set an example for
the integrated care efforts of other countries. However, further human resource development,
improvement of the competence level of APNs, and further integration of social and
health resources are needed in order to create a better incentive system. In the continuation
of this programme the development and sustain the care pathway management is also
needed, connecting home, day care and ambulatory care platforms.
