Und wer sagt das keine Krankenhäuser oder Infrastruktur gebaut wird? Auch außerhalb Skopjes!
Health care
http://vlada.mk/?q=node/263&language=en-gb
Health care
Сподели
Health is a factor that affects the social position of the population and is a condition for economic growth of the country. Therefore, the Government of the Republic of Macedonia will make efforts for development of a health system that will improve, promote and sustain the health of all citizens, a system that will be based on equality and solidarity and a system that will bear in mind the citizen’s real needs. Main priorities for the next four years will be: raising the health service quality at all levels, strengthening the primary health care and prevention, and establishing a stable system for financing the health care of all citizens.
Raising the health service quality at all levels
To promote the public health, in the following four–year period new disciplines will be developed and new necessary treatments in the public health will be introduced, by:
Prescribing a legal obligation for practicing medicine based on evidence, and the doctors will be legally bound to apply it in their everyday practice. (December 2013);
We will introduce standardized procedures which will be raised to a level of protocol for improving the work quality in the public and private health care facilities by establishing standards and control mechanisms to monitor their application (December 2013);
An Agency for Accreditation of the Health Institutions will be established that will prepare the standards in cooperation with the Ministry of Health and will continuously monitor and assess the quality of the work in health institutions and the application of evidence–based medicine (June 2012);
The safety of the patients will be increased and the risk of working in hospitals will be reduced by applying and developing clinical pathways for patients with different diagnosis;
Standardizing the procedures and processes refers to setting standards for equipment, staff and space, protocols of the total procedure of treatment from an expert medical aspect (December 2014);
Establishing Cardiology Network for Treating Acute Heart Infarct in the public health care by equipping the regional hospitals with modern and sophisticated equipment and staff training for the initial treatment which is critical for saving lives (June 2014);
Promoting the methods of tissue and organ transplantation, especially emphasizing kidney and liver transplantation in the public health care. By enabling kidney transplantation the number of patients who have to undergo dialysis will be reduced and the quality of life of these patients will be increased (June 2012);
Establishing a COMA center, in which services and appropriate modern treatment of patients, who have been in a coma for a longer period, as well as for long–time patients, will be combined (December 2013);
Training the health care staff by experienced foreign experts through the network of world renowned universities, by Memoranda of Collaboration at all 27 university clinics and institutions (2012–2015);
Accreditation of the laboratory and other services that are provided by university institutes (2012–2015);
Introducing an obligation for every health care institution to publicly disclose on its web page all the carriers of activities and all the doctors in the health care institution, with determining the days and time of their working shifts in order to ease the scheduling of visits and check–ups (December 2011);
Establishing a Center for telephone appointments and examinations of citizens in the secondary and tertiary level in order to alleviate the access to specialist – consultative services, hospitals and clinics in the public health care and to reduce the waiting time for specific health care services and diagnostic procedures;
Introducing a System for Measuring the Efficiency in the Work of Health Care Institutions based on the health care services and financial rationality in using the funds through measurable criteria on success and the quality of the serviced health services. A National Committee for Financing will be founded, which, on the grounds of established criteria will monitor the performance of the public health care institutions and the health care staff (continuously);
Accessibility of all needed medication for the patients in the hospitals according to evidence–based medicine by abolishing the hospital positive drug list covered by the Health Insurance Fund of Macedonia (HIFM) (April 2013);
Forming of a modern National Center for Emergency Medicine, for taking care of all the citizens that are in imminent life–threatening situations and where they will receive quality and prompt health care service (June 2014);
Forming of units for emergency medicine for conducting triage of emergency cases in regional hospitals and their linkage with the National Center for Emergency Medicine for the availability of timely health intervention throughout the territory of the Republic of Macedonia (2012–2015);
Establishing a new educational program for emergency medicine specialization within the programs of the Medical Faculty at the University “Ss. Cyril and Methodius” (October 2012).
Strengthening the primary health care and prevention
The Government will continue promoting the primary health care system through quality services provided by an organized network of public health care institutions for urgent, primary and preventive health care. Moreover, the reorganization and strengthening of the Health Homes will be especially emphasized, in order to provide an integrated access in the patient care, cooperating with the general practitioners, who in the coming years, will be transformed into family medicine specialists. In the period 2011–2015 we will commit ourselves to:
Improving the Urgent Medical Assistance, by procuring at least 50 new vehicles. (2012–2013);
Forming of Urgent Medical Assistance call centers throughout the Republic of Macedonia (April 2013);
Promoting the primary health care through providing priority and necessary health care services and counseling the citizens in their homes through the concept of family doctors and strengthening Urgent Medical Assistance. Thus, the trainings for introducing family medicine specialists will continue (2012);
Promoting with equipment and staff of a polyvalent (multifunctional) patronage service within Health Homes, their reorganizing and strengthening by increasing the number and type of services, focused on the population in rural areas (April 2013);
Promoting the preventive health care by cooperating with the local authority and public healthcare centers for developing projects based on regional priorities for improving the health of the population (continuously);
Developing an integrated preventive program based on priority illnesses of interest to all citizens and its implementation by the Public Health Institute in collaboration with the Public Health Centers (2012);
Continuing the campaign for free HPV vaccines to prevent cervical cancer among women (continuously);
Free hospital treatment for pensioners housed in hospitals and clinics, if their pension is lower than the average in the Republic of Macedonia (January 2012).
Stable system for financing the health care for all citizens
The Government will continue to work on improving the financing of the health care system with an inflow of additional funds, and based on obtained relevant data for the expenditures in the health care, a more efficient allocation of resources will be established. The policy of increasing the budget of the Health Insurance Fund of the Republic of Macedonia (HIFRM) will continue through expanding the base for collection of the contributions as a result for decreasing unemployment, increasing the number of the insured and strict financial discipline of the expenditure side. Also, the possibility for redefining the health care service packages will be reviewed. Simultaneously, we will continue with the measures for more responsible management of the HIFRM and increased transparency during the negotiations with health care institutions by forming a Multilateral Commission, within which, besides the HIFRM and the Ministry of Health, the Trade Union, the insurers, Chambers and professional associations of health care workers will have their representatives. We will shorten and speed up the procedures for implementation of the rights of the insurers in relation to the decisions issued by the HIFRM. In order to improve the record–keeping, we will realize a Project for the Institutionalization of National Health Accounts, through an information system with all the information on how the health care money is being spent.
For the implementation of the priorities in the field of health care in the period 2011–2015 the following projects will be fulfilled:
Investments in renovating the infrastructure of:
Surgeon Clinics in Skopje, the Radiology Institute, the Emergency Center, the Clinic for Children’s Diseases, the Hematology Clinic, the Cardiology Clinic, the Infectious Diseases Clinic, Lung Disease Institute, Psychiatry Clinic, the State Institute for Transfusiology, St Naum of Ohrid Clinic for Surgical Illnesses, The Lung Illnesses Institute – Kozle, the Special Hospital for Gynecology and Obstetrics – Chair;
The commenced activities in the hospitals in Tetovo, Strumica, Veles, Prilep, Ohrid, Kumanovo, Gevgelija, Gostivar, Kichevo, Kochani, Special Hospital Jasenovo – Veles, Nephrology Institute Struga, the Psychiatric Hospital in Skopje „Bardovci”, and the Psychiatric Hospital Negorci will be completed;
Construction of a new hospital and building for the Medical Faculty in Shtip.
Renovation of the clinical hospital in Bitola, the general hospitals in Kichevo, Struga, the Psychiatric Hospital Demir Hisar, and the Health Care Facility in Ohrid and the City Hospital "8. September" Skopje (ex Military Hospital) is envisaged.
Continuing the activities for the building preparation of a new Clinic Center in Bardovci (dislocating in a new clinic center in 2021);
Investing in a complete renewal of doctors’ offices by procuring non–medical equipment for the hospitals and clinics (2012–2014);
Continuing the project for procurement and putting into use of cutting edge medical equipment, in order to raise the quality of the health care services and the health care situation of the population as a whole (September 2013). Installing the equipment and education of the staff will be conducted in the following institutions:
The three clinical hospitals in Tetovo, Bitola and Shtip, which plan to procure an apparatus for computerized tomography, magnetic resonance imaging apparatus (MRI) with magnetic field strength 1.5T, lithotripter, angiograph, bone densitometer, cardiologic echo–apparatus, gynecological 4D echo–apparatus, incubators, etc.
Apparatus for computerized tomography will be set up in the general hospitals in Veles, Gostivar, Ohrid, Kumanovo, Prilep and in Strumica.
Procurement and installing cutting edge technology and staff education in all general hospitals, where there will be one Cardio–Ultrasound Apparatus, Gynecological 4D ultrasound apparatus and a radiological ultrasound apparatus, along with anesthesia apparatuses, central and individual monitoring, mechanical ventilation machines (pediatric and adult), endoscopic cabinet and a surgical instrumentarium.
Complete equipping of the new City Hospital “8. September” in Skopje, which includes several diagnostic, surgical and interventional devices.
Procurement and installing of cutting edge equipment and staff education in the University Radiology Clinic, University Cardiology Clinic, University Clinic for Surgical Diseases “St. Naum Ohridski”, University Clinic for Child Diseases, the Cardiovascular Diseases Hospital in Ohrid, the University Clinic for Radiotherapy and Oncology, the General Hospitals in Ohrid, Gostivar, Veles, Prilep, Kumanovo, Strumica, Kochani, Kavadarci, Gevgelija, Debar, Struga and Kichevo.
Construction and equipping of a cutting edge PET center (Center for Positron Emission Tomography), through which Macedonia will become a regional PET center.
Investing in reconstruction and repairing the central buildings of 34 Health Homes, most of which are older than 50 years (2012–2015);
An integrated health care information system and an Electronic Health Card, which will replace the paper booklet and blue cards. (2012–2020);
Public–private partnership in dialysis centers, stem–cell centers and everything which will improve the quality of health care services to the citizens (continuously);
Introducing E–checks, E–Invoicing, E–Introducing of Е–Checks, Е–Invoicing, Е–Registration, Е–Insurance through the centralization of the IT system of the HIFRM which will enable electronic register/logout of the insurers, thus saving time and resources (2011–2013);
Prescription medications from the 1st to the 31st in the month by gradually abolishing pharmacy quotas. By abolishing the quotas, we will enable the pharmacies to be fully stocked with medications for the insurers and function well for 24 hours a day (2012);
Introducing a six–month therapy prescription for the chronically ill patients in order to reduce the administrative work done by doctors, higher contentment of the insurers and more effective means of prescribing medications (December 2011);
A transparent commission for the medications on the positive list, by a clear legal prescribing how the medication could enter the positive list, which will enable the fulfillment of the patients’ needs with the right medication (April 2012);
We will enable direct access and operability between HIFRM and Patients’ Associations by introducing a regular monthly meeting (September 2011);
Care for the persons with special needs by introducing aids for blind persons, as well as strengthening the cooperation with the physically disabled persons, blind persons and deaf and hearing impaired persons, in order to meet the needs of these individuals. (September 2011);
Introduction of e–Registries of patients with specific diseases for an electronic monitoring of patients’ supply with therapy from the hospital medication list (2011–2012);
Defining minimal standards required by any incorporated material covered by the HIFRM that directly affects the service the patient receives (June 2012);
Forming Children’s Corners within hospitals. (2012–2015);
24–hour a day mobile HIFRM control, according to which the insurers will have the opportunity to report an irregularity or ask for help from the HIFRM, in case any other health care institution fails to provide them with the service or treatment to which they are entitled. (April 2012);
Maximal amount of insurers’ participation for treatment abroad will be 12,000 denars. (April 2012–2015);
Continuing the IN Vitro project covered by HIFRM by increasing the coverage and the insurers who already have offspring from previous unions, as well as for couples carrying genetic disorders (continuously);
Expanding the possibility for bio–medically assisted insemination to provide INVIVO or aided insemination covered by HIFRM in private institutions that do in vitro inseminations up to 4 times (June2012);
Hospital map for locating the health care services and appropriate coverage of the regions (December 2011);
HIFRM offices in smaller municipalities, too;
Forming a new Medical Body for Supervision and a National System for Reporting from the four relevant health care institutions: the Doctor's Chamber, the Pharmaceutical Chamber, the Ministry of Health and HIFRM (December 2011);
Opening a center for elderly diseased with cystic fibrosis (CF) and education of medical personnel – physiotherapists for this illness (June 2012);
Promoting methodology for establishing the unique and referential prices of medications, thus further reducing the prices of medications in pharmacies (April 2012);
Better treatment and care for persons treated in psychiatric institutions (September 2013);
Introducing Telemedicine – Remote Medicine, online education and monitoring the ill, where by using cutting edge technologies, it will be allowed for the patient to carry out the medical examinations at one place and to send the results to a doctor residing in another health care institution in the country or abroad. (2012–2015);
Protecting the young population by employing pediatricians in the municipalities. Local authorities will stimulate children’s health care by employing pediatricians, that is, financing their specialization, with the obligation to serve the children in the region for at least 10 years (2013–2015);
Paying hospital doctors according to their performance, which depending on the size and type of the PHI (Public Health Institution), will provide an increase in the monthly salary up to 100% of the base wage for three to five of the most successful doctors on the basis of their performance (December 2011);
Project: “Rural Area Outpatient Hospital”, which will provide the construction of new outpatient hospitals in Katlanovo – Skopje, Lokvia – Makedonski Brod, Manastirec – Makedonski Brod, Crn Vrv – Skopje, Malo Konjare – Prilep, Trsino – Vinica, Kalugjerica – Radovish by the end of 2011;
Revitalizing the empty and abandoned rural area outpatient hospitals and reconstructing and repairing the existing old buildings (2013–2014);
Opening rural area pharmacies at 8 locations: Staro Nagorichane, Karbinci, Konche, Bogomila, Jegunovce, Mavrovi Anovi, Vraneshnica and Drugovo (December 2012).
Establishing a system of mobile pharmacies to supply necessary medication especially for rural area citizens who live remotely from pharmacies and for the old, frail and chronically ill. (2013)