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The sustainable development of healthcare in the 21st century requires a paradigm shift in medicine and in doctor-patient relationships. As life expectancy rises, and the proportion of chronic patients increases, health-costs rise to the extent that social spending cannot keep with. Healthcare can only be achieved through new types of care systems, an important new element of which is the active involvement of patients in the healing process. The physician-patient relationship based on the passive role of the patient should be replaced by a relationship based on reciprocity and partnership, in which the patient plays an active role in managing his or her health and illness. Developing this role of patients requires well-informed individuals with health responsibilities and a health care system responsible for evolving these skills. Health literacy development needs to be started in schools and then integrated into lifelong learning. Special self-care support systems need to be put in place to address the growing need for care of people with chronic illnesses. Based on professional aspirations, initiatives for operable systems exist in Hungary for some group of patients at present, however, these solutions are not coordinated and not integrated into the healthcare structure, and financing their costs is not solved. To strengthen the self-care of patients, a unified framework must also be established in Hungary, which creates the conditions for patient education tailored to the capacity and skills of patients. Development of effective techniques is needed for supporting lifestyle changes that are typically essential in chronic diseases. The activities of patient organizations and non-medical graduate health professionals – such as pharmacists, graduate nurses, dieticians, physiotherapists – are highly valued in establishing self-care. In the age of rapidly evolving info-communication technologies, we must focus on monitoring lifestyle and physiological parameters in the patient’s home, applying intelligent decision-support solutions based on these data, and utilizing remote consultation options in selected cases. Kulcsszavak: öngondoskodás, egészségértés, betegedukáció, betegszervezetek, gyógyszeré-

magyar tudomány

A betegszerep felértékelődése a 21. századi egészségügyi ellátásban: öngondoskodás támogatása, egészség-magatartás fejlesztése komplex ellátási rendszerben