CEREREA INDUSA LA NIVELUL SERVICIILOR SPITALICESTI DIN BULGARIA - TENDINTE ACTUALE SI FACTORI
Journal Title: Management in Sanatate - Year 2011, Vol 15, Issue 4
Abstract
Context. Schimbarea management-ului si finantarii sistemului de sanatate din Bulgaria, dupa anul 2000, a condus la aparitia a noi probleme in organizarea si managementul activitatii medicale, in special in ceea ce priveste imgrijirile spitalicesti, probleme ce au aparut dupa adoptarea Legii Unitatilor Medicale, in anul 1999. Probleme serioase privind serviciile spitalicesti au aparut in legatura cu cererea indusa pentru serviciile spitalicesti care contribuie la supra-spitalizare si cheltuieli suplimentare. Scopul acestui articol este de a explora tendinta evolutiva a spitalizarilor si de a analiza principalii factori determinanti ai supra-spitalizarii. Metode. Analiza este bazata pe rapoartele anuale financiare ale Casei Nationale de Asigurari de Sanatate (NHIF) din Bulgaria, pe statisticile anuale de sanatate publica publicate de catre Centrul National de Informatica in Sanatate, si pe date corespondente pentru tarile europene colectate din baza de date Health for All, la nivelul anilor 2000-2009. Rezultate. In perioada analizata (zece ani), cheltuielile serviciilor spitalicesti au crescut pana la 390%, in timp ce PIB-ul a crescut, in valoare reala, cu doar 47%. Numarul de internari a crescut de peste 2 ori (de la 738 978 in anul 2000, la 1 769 230 in anul 2009). Punctul critic al cresterii a fost observat in perioada 2005-2006, cand intreaga finantare a serviciilor spitalicesti a fost preluata de catre NHIF. Concluzii. Principalele motive ale cresterii enorme a numarului de internari a fost legat, in principal, de cresterea cererii induse pentru serviciile spitalicesti, trimiteri ineficiente si tratarea afectiunilor cornice in spitale pentru acuti, neincrederea pacientilor in calitatea ingrijirilor ambulatorii, eficienta scazuta a asistentei primare, supraveghere si reglementare necorespunzatoare din partea NHIF. Politica de sanatate si management spitalicesc neadecvate si ineficiente orientate mai mult spre furnizorii de servicii medicale si mai putin spre nevoile pacientilor.
Authors and Affiliations
Tony J. VEKOV, Silviya Aleksandrova-YANKULOVSKA, Gena GRANCHAROVA, Nadia VELEVA, Makreta DRAGANOVA
Keywords
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- EP ID EP86411
- DOI 10.5233/mih.2011.0024
- Views 126
- Downloads 0
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