1.
Family physician
Family (chosen) physician will become the pillar of health care protection in the following period. In most European countries those are individuals in private practice who, based on the number of patients who wish to be treated by them, make a contract with the health care protection fund. They will be interested in having as much patients as possible, because the fund will pay them according to the number of patients and they will be less stimulated to send them to specialists. By that means savings and reduction of necessary capacities and staff in secondary health care institutions are achieved. They would, in large part, take over most of pediatric and gynecology problems, what is largely needed in distant suburb regions.
2.
Pressure of the terminally ill patients
Svedoci smo porasta broja malignih oboljenja i sledstvenog povećanja broja pacijenata kojima je potrebna palijativna nega. Trenutno ne postoje kapaciteti u zdravstvenim ustanovama koji bi mogli preuzeti ovu funkciju, ali je to predviđeno u programu restrukturiranja - rešenje se nudi smanjivanjem kapaciteta RJ Opšta bolnica i uvođenjem određenog broja kreveta za ovakve slučajeve.
3.
Pressure of patients with geriatric problems
The increasing number of elderly people is a fact that should be seriously considered when planning the organization of the health care service. Solution is the same as mentioned in the previous point.
4.
Abolition of enterprising offices
Common occurrences in the past years are enterprising offices within the Health Care Work department. However, they are slowly shutting down and in a few years there will probably be only the Dispensary for Work Medicine left, which will deal in specific problems form its own area. Patients employed in factories will have their medical file with their family physician, so unneeded doubling of capacities will be avoided.
5.
Shutting down of specialist services outside of the General Hospital
According to the vision of reform in health care, no specialist services outside institutions of secondary and tertiary health care protection are foreseen. Dispensary for tuberculosis, Specialist service within the Health Care Center and the Dispensary for health care protection of women and children are some of the parts of the Medical Center Subotica for which financing and working conditions should be solved in light of the mentioned plan. There will surely be a long transitional period in which this can be resolved in as much painless way as it can. There is extreme dissatisfaction of the citizens because in many distant offices of the Health Care Center, e.g. the pediatrician no longer comes – there is a need for broader action which will prepare the citizens and explain to them what kind of system of health care protection is coming. It is especially important to emphasize that in that way there is no reduction in the quality of health care protection, but it is only redirected to the family physician. Pediatrician (and other specialist) service will be consultative and not in the form of primary protection.
6.
Reorganization of general practice offices network
The citizens should also be explained the fact that today’s health care system is too big, not economical and that it is often the case that an unnecessary number of offices are found in close vicinity. This problem can be solved only by planning a network of these institutions, in consulting with citizens and local management, paying attention to standards which exist in Europe.
7.
Reducing the number of doctor specialists
Nowadays the number of doctor specialists is too great in relation to the number of general practice doctors 6:1 (in the European Union it is 1:1). Reduction of doctor specialists is expected and the regime of receiving specializations is already more strict than in past years.
8.
Capacity reduction in the General Hospital
As it was said, with the restructuring of hospital capacities, there will be, among other things, a reduction in the number of beds. That would lead to savings in treatment and a reduction in days spent in hospital. All this is possible only under the condition that the hospital and corresponding specialist services are equipped with suitable equipment which facilitates diagnostic and therapeutic procedures be done in a less aggressive, faster and less painful way, which ultimately brings about the shortening of hospital stay.
9.
Surroundings, entering the EU – competition
The fact that should not be forgotten is that in the following years our country is inevitably going to join the European Union. That brings up many questions, and on the first place is whether our health care institution will be sufficiently equipped and efficient to be able to compete with other medical – university centers nearby. Patients will always pick that institution where they will get the most sophisticated and best quality service. We cannot be unprepared for those market conditions. |
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