Záverečný workshop ,,Zdravotníctvo 2020“ | Medicínske právo
              

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Záverečný workshop ,,Zdravotníctvo 2020“


 | 21.9.2011 | komentárov: 290

Na ministerstve zdravotníctva bol 19. septembra 2011 štvrtý, záverečný workshop Fórum „Zdravotníctvo 2020“. Jeho účastníci diskutovali na tému „Reformné kroky pre fungujúce zdravotníctvo.“

Obrazok
V úvode stretnutia sa prítomným prihovoril minister zdravotníctva Ivan Uhliarik, nasledovali vstupné prednášky a diskusia. Členovia fóra odsúhlasili nadpolovičnou väčšinou hlasov základné princípy, ktoré sa dotýkajú financovania a ekonomiky slovenského zdravotníctva pre Zdravotníctvo do roku 2020:


• Podiel verejných zdrojov na financovaní zdravotnej starostlivosti na Slovensku by nemal poklesnúť pod hodnotu 70 %.
• Systém verejného zdravotného poistenia by mal byť pluralitný s viacerými konkurujúcimi si zdravotnými poisťovňami.
• Vláda SR by mala vytvárať podmienky na vytváraní konkurenčného prostredia v oblasti zdravotného poistenia.
• Systém verejného zdravotného poistenia by mal ponúkať diferencované balíky služieb pre rôzne skupiny poistencov.
• Financovanie unikátnych funkcií univerzitných nemocníc je úlohou vlády SR.
• Financovanie verejného zdravotníctva je úlohou vlády SR.
• Investície do rozvoja centier excelencie sú úlohou vlády SR.
• Investície do zariadení poskytovateľov zdravotnej starostlivosti sú úlohou zriaďovateľa a majiteľa. Štát by mal zabezpečiť stabilné legislatívne prostredie.
• Súčasťou stabilného legislatívneho prostredia je predĺženie minimálnej doby platnosti zmluvných vzťahov medzi poskytovateľom a zdravotnou poisťovňou na dobu odpisovania investícií t.j. 4 roky.
• Definícia vhodnej právnej formy pre poskytovateľov ústavnej zdravotnej starostlivosti, ktorá bude garantovať zabezpečenie transparentnosti hospodárenia, tvrdé rozpočtové obmedzenia, prehľadné účtovníctvo, transparentné výberové konania a povinnosť auditu.
• Redukcia rozsahu zdravotnej starostlivosti hradenej z verejného zdravotného poistenia a možnosť pripoistenia za nadštandardnú zdravotnú starostlivosť.
• Implementovať platobnú metódu DRG pre poskytovateľov ústavnej zdravotnej starostlivosti.
• Mal by sa vytvoriť arbitrážny orgán na posudzovanie sporov medzi poskytovateľom a platiteľom zdravotnej starostlivosti.
 
V ďalšej časti fóra odsúhlasili nadpolovičnou väčšinou hlasov základné princípy, ktoré sa týkajú reformných krokov pre fungujúce zdravotníctvo do roku 2020:

Dostupnosť zdravotnej starostlivosti:

• Neodkladná zdravotná starostlivosť pomocou vozidiel Záchrannej zdravotnej služby (ZZS) by mala byť dostupná v každom regióne SR maximálne do 15 minút od nahlásenia náhlej udalosti po príjazd vozidla ZZS.
• Základná neodkladná zdravotná starostlivosť v zariadení ústavnej zdravotnej starostlivosti (t.j. základné odbory, ako sú: interná, chirurgia, gynekológia, pediatria, neurológia, ÁRO) by mala byť fyzicky dostupná v každom regióne SR maximálne do 60 minút od nahlásenia náhlej udalosti po poskytnutie nevyhnutnej odbornej zdravotnej starostlivosti.
• Vysokošpecializovaná neodkladná zdravotná starostlivosť v zariadení ústavnej zdravotnej starostlivosti (t.j. mimo základných odborov, ako sú: interná, chirurgia, gynekológia, pediatria, neurológia, ÁRO) by mala byť na Slovensku dostupná do 6  hodín od nahlásenia náhlej udalosti po poskytnutie nevyhnutnej  vysokošpecializovanej zdravotnej starostlivosti.
• Zdravotné udalosti, ktoré si vyžadujú neodkladnú zdravotnú starostlivosť by mali byť detailne zadefinované.
• Neodkladná zdravotná starostlivosť je za každých okolností v plnej výške uhrádzaná systémom verejného zdravotného poistenia.
• Plánovaná zdravotná starostlivosť u detí by mala byť poskytnutá do 3 mesiacov  od indikácie poskytnutia zdravotnej starostlivosti.
• Plánovaná zdravotná starostlivosť u dospelých by mala byť poskytnutá pri diagnostických výkonoch do 6 mesiacov a pri liečebných výkonoch do 9 mesiacov od indikácie poskytnutia zdravotnej starostlivosti.
• Zdravotná starostlivosť v rozsahu ošetrovateľskej starostlivosti je základným pilierom  pre dlhodobú starostlivosť v domácom prostredí.
• Dlhodobá zdravotná starostlivosť v rozsahu ošetrovateľskej starostlivosti o chronicky chorých, imobilných a geriatrických pacientov by mala byť poskytovaná v čo najväčšej miere v prirodzenom prostredí pacienta.
• Dlhodobá zdravotná starostlivosť v rozsahu ošetrovateľskej starostlivosti o chronicky chorých, imobilných a geriatrických pacientov by mala byť adekvátne financovaná z verejných zdrojov nad rámec súčasného verejného zdravotného poistenia.
• Vypracovanie podmienok a systému financovania dlhodobej zdravotnej starostlivosti v rozsahu ošetrovateľskej starostlivosti o chronicky chorých, imobilných a geriatrických pacientov je úlohou štátu.
• Poskytovanie dlhodobej zdravotnej starostlivosti v rozsahu ošetrovateľskej starostlivosti o chronicky chorých, imobilných a geriatrických pacientov je úlohou súkromných a verejných poskytovateľov.
 
Ľudské zdroje:

• Ľudské zdroje v zdravotníctve (zdravotnícki pracovníci) sú najcennejším aktívom slovenského zdravotníctva.
• Rozvoj ľudských zdrojov je spoločnou úlohou štátu, majiteľa zdravotníckeho zariadenia  a zdravotníckeho pracovníka.
• Na financovaní vzdelávania zdravotníckych pracovníkov sa rovným dielom majú podieľať všetky tri zainteresované strany, t.j. štát, majiteľ zdravotníckeho zariadenia a zdravotnícky pracovník.
• Vzdelávanie zdravotníckych pracovníkov by malo byť pre každého zdravotníckeho pracovníka cenovo, fyzicky aj časovo dostupné.
• Špecializačné vzdelávanie lekárov by malo byť ťažiskovo v univerzitných nemocniciach.
• Špecializačné vzdelávanie iných zdravotníckych pracovníkov by malo byť ťažiskovo vo fakultných nemocniciach.
• Každé zdravotnícke zariadenie, v ktorom je  špecializačné vzdelávanie by malo mať verejne dostupné študijné plány pre každý odbor tohto vzdelávania.
• Hodnotenie kvality špecializačného vzdelávania je úlohou štátu.
• Hodnotenie kvality celoživotného vzdelávania je úlohou stavovských organizácií.
 
Prioritné ochorenia:

• Koordinácia štátnych intervencií v rámci primárnej prevencie vysokoprevalentných ochorení je úlohou Úradu verejného zdravotníctva SR, vrátane prípravy legislatívy, financovania intervenčných programov a disseminácie informácií a poznatkov.
• Koordinácia štátnych intervencií v rámci sekundárnej prevencie vysokoprevalentných ochorení je úlohou Ministerstva zdravotníctva SR, vrátane prípravy legislatívy, financovania intervenčných programov a disseminácie informácií a poznatkov.
• Koordinácia štátnych intervencií v rámci znižovania incidencie zriedkavých ochorení je úlohou Ministerstva zdravotníctva SR, vrátane prípravy legislatívy, financovania intervenčných programov a disseminácie informácií a poznatkov.
• Štátne intervencie pri prevencii ochorení by mali byť riadené projektovým riadením s jasnými cieľovými parametrom úspechu a pravidelným vyhodnocovaním projektov.
• Štát by mal koncentrovať štátne intervencie na prevenciu vzniku ochorení, ktorých prevalencia presiahne 1/100 obyvateľov, alebo ktorých dopad na kvalitu života populácie presiahne definovanú hodnotu QALY.
 
Pacient:
• Zvyšovanie zodpovednosť pacienta za svoj zdravotný stav.
• Zoptimalizovanie spoluúčasti pacienta ako regulačného nástroja dopytu zdravotnej starostlivosti.


zdroj: health.gov.sk
foto: sme.sk




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