10/22/2015 AER Social Politics & Public Health Committee 2, Katowice ( Slaskie, PL ) A REVIEW OF THE...

04/21/23 AER Social Politics & Public Health Committee 2, Katowice ( Slaskie , PL )

A REVIEW A REVIEW OF THE OF THE HEALTH SYSTEM IN HEALTH SYSTEM IN

ROMANIAROMANIA 2009 2009


HEALTH SYSTEM HEALTH SYSTEM

The major objective The major objective is represented by the is represented by the improvement of life quality for Romanian improvement of life quality for Romanian people through increasing the population healtpeople through increasing the population health. h.


The The achievement achievement of of this desideratum will be governed this desideratum will be governed by by management principles established for the whole management principles established for the whole health system: health system:

decentralization and decisional responsibility;decentralization and decisional responsibility; sustaining the competition in assuring the sustaining the competition in assuring the medical care; medical care; general efficiency and transparency in general efficiency and transparency in administration and administration and in in spending spending the the money money of the of the tax payers. tax payers.




Analyzing the pathology of the health system we Analyzing the pathology of the health system we can observe that the difficulties are based on: can observe that the difficulties are based on: the lack of reformthe lack of reform the overload with tasksthe overload with tasks the centralizationthe centralization the lack of a coherent vision.the lack of a coherent vision.


The major issues of the health The major issues of the health system are:system are:

1.1. poor poor endowment endowment ofof hospitals, hospitals, bad and bad and old apparatus;old apparatus;2.2. high quality apparatus unused because the specialized high quality apparatus unused because the specialized

personnel is missing from the medical unitpersonnel is missing from the medical unit3.3. lack of the specialized personnel from certain areas lack of the specialized personnel from certain areas

considered not attractive: considered not attractive: inin primary medical care, in primary medical care, in ambulatory ambulatory care care and hospitals, in the department for and hospitals, in the department for compensatory drugs, compensatory drugs,



The The Major Priorities Major Priorities are represented by are represented by actions:actions:

for problems with immediate for problems with immediate effecteffect for structural reform.for structural reform.



It is necessary to ellaborate a strategy for a medicine policy

Advantages:Advantages:it will improve the accessibility to the essential drugsit will improve the accessibility to the essential drugsit will allow the quick implementation of a social program it will allow the quick implementation of a social program without affecting the health security fundwithout affecting the health security fundthe social program regarding the compensate drugs for the social program regarding the compensate drugs for pensioners is for those with incomes less than 600 lei, they will pensioners is for those with incomes less than 600 lei, they will buy drugs 90% compensate in limits of 100 lei per person per buy drugs 90% compensate in limits of 100 lei per person per year.year.



It is necessary to ellaborate a strategy for a medicine policyMain actions:to establish andto update the prices at a unique yearly rate fixed in lei, correlated with the capacities purchased from the providersgeneric prescription through generalization of the prescription based on International Nonproprietary Name (INN) in accordance with WHOto improve the access to the medical services through developing a new health policy in rural areas.



AAchievchievmentment Mechanisms : Mechanisms :

increasincreasinging the reward for the medical the reward for the medical personnel personnel fromfrom rural areas, areas were the rural areas, areas were the health care is not present in this momenthealth care is not present in this momentnew ways of primary assistance based on new ways of primary assistance based on multidisciplinary teams to multidisciplinary teams to enensure the sure the continuity in treatmentcontinuity in treatment



MMembers embers of the pof the primary care team :rimary care team :

family doctors GPfamily doctors GPnurses, midwifesnurses, midwifessocial workerssocial workersphysical-therapists.physical-therapists.



At At local local level level the creation of the following the creation of the following is necessary :is necessary :

care centers, including the minor affections, care centers, including the minor affections, with permanent personnel with average with permanent personnel with average qualifications, allowing a range of activities qualifications, allowing a range of activities without the need of a doctor.without the need of a doctor.



At At macro-structural levelmacro-structural level organizational and organizational and decisional decentralization is needed.decisional decentralization is needed.

Means Means to achieve this objective:to achieve this objective:•the hospitals will be subordinate to the local authorities, creating the hospitals will be subordinate to the local authorities, creating the conditions to be more responsible for those that take decisions the conditions to be more responsible for those that take decisions in the field of in the field of health services health services•regional hospitals, of national importance with emergency units will regional hospitals, of national importance with emergency units will remainremain under the coordination under the coordination of the of the Health Ministry.Health Ministry.



It is necessary to develop guidelines and It is necessary to develop guidelines and therapeutically protocols in collaboration with therapeutically protocols in collaboration with the specialists from the whole country and the specialists from the whole country and abroad for the most frequent affections in abroad for the most frequent affections in accordance with the international accordance with the international methodology.methodology.



GGuidelines and protocols will be uidelines and protocols will be developed for:developed for:

CVCVIschemic cIschemic cardiopathy and myocardialardiopathy and myocardial infarction infarctionhigh blood pressurehigh blood pressureChronic lung diseasesChronic lung diseasesBreast cancerBreast cancer, , uterine cancer,uterine cancer, prostate cancer, prostate cancer, colcolonon cancer cancer DiabetDiabeteses



For the For the functioning of the informational functioning of the informational systemsystem for family’s doctorsfor family’s doctors::

to publish monthly the prescriptions on the health to publish monthly the prescriptions on the health security sitesecurity site to publish monthly the to publish monthly the cost generated by the cost generated by the contract with the drug stores and contract with the drug stores and medical medical laboratorlaboratoriesies on the health security siteon the health security site



The goal of these actions is:The goal of these actions is:

to increase the access to increase the access toto medical care and the quality of the health medical care and the quality of the health services through expanding the services in the rural areasservices through expanding the services in the rural areas to increase the populationto increase the populationss access to health products and services access to health products and services to improve the process and costs within the system using the to improve the process and costs within the system using the prevention in medical careprevention in medical care to increase the access to primary services that will lead to diminishing to increase the access to primary services that will lead to diminishing the overload the overload with with hospitals cases hospitals cases so so the hospitals will be able to the hospitals will be able to concentrate their medical, therapeuticallyconcentrate their medical, therapeutically and administrative efforts to and administrative efforts to patients that need hospital care in accordance with European medical patients that need hospital care in accordance with European medical norms, rules and proceedings norms, rules and proceedings



After the dissection of the health system After the dissection of the health system we can list the difficulties generated we can list the difficulties generated mainly bymainly by::

Lack of reform Lack of reform Task overload Task overload Centralization Centralization Lack of aLack of a vision vision



Thank you for your attention!Thank you for your attention!

Cătălin TIUCH Cătălin TIUCH

Timis County Council Timis County Council [email protected]


10/22/2015 AER Social Politics & Public Health Committee 2, Katowice ( Slaskie, PL ) A REVIEW OF THE...

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