[ad_1]
The bill, first presented to the Health Affairs Committee on Wednesday, plans to reduce the number of active treatment beds and integrate the ambulance system.
As Deputy Minister Danguolė Jankauskienė said during the committee meeting, the plan will later be presented to other partners and additional working groups will be created.
The Economic Recovery and Resilience Fund (FRR) contributes 268 million euros for this transformation. 530 million euros of investments from the European Union. euros.
“We have anticipated a large and sufficient need for funds to implement this reform,” he said.
Offers to expand hospitals
According to her, criteria have been established on how many beds each hospital should have in order for its operation to be sustainable and economical. Therefore, the objective will be to maintain not many small hospitals in the big cities, but a larger one.
“The health insurance fund has developed (…) criteria for us: the minimum number of cases in hospitals in which a hospital can be sustainable. I want to ask that you do not be intimidated by this criterion, because it seems that there are no many hospitals, but in reality it is not. But the Health Insurance Fund says that the minimum hospital that can be maintained in terms of rates, number of employees, security is a 90-bed hospital with 4 thousand cases per year “, said D. Jankauskienė.
Consequently, hospitals with more than one profile should have a correspondingly larger number of beds and cases. Transition periods would be provided for medical institutions and smaller municipal institutions would be integrated into the provision of primary services.
“I want to emphasize that we do not intend to close any hospital or institution,” emphasized the deputy minister.
Encourage cooperation
However, he said, the institutions will be encouraged to work together, both through financial means and through various agreements.
Related to this is the proposal for the reorganization of primary health care, proposing the creation of networks of community health and long-term care services from small hospitals and other municipal institutions, as well as the structural or functional fusion of institutions. through cooperation agreements.
The municipalities would decide for themselves whether hospitals, polyclinics or individual institutions with cooperation agreements would provide health services to the communities.
“But cooperation agreements will be our condition,” emphasized D. Jankauskienė.
The municipalities plan to create a long-term care network for disabled and sick people. It would integrate health and social services, and the ministry would develop criteria on how these services would be integrated with other services through cooperation agreements.
Centralize the ambulance
The ministry has developed a model to ensure that people in all areas receive emergency medical care on time and can receive the necessary emergency care in a hospital within an hour.
This would require an increase in the number of ambulance duty stations from 94 to 123, but a slight increase in the number of brigades themselves to just three, from 218 to 221.
Currently, ambulance services are provided by 49 legal entities, coordinated by five dispatchers, and the work between them, according to the vice minister, does not always go well, so it is proposed to centralize them.
“The different ambulance stations belong to different jurisdictions, that is, municipalities, inequalities due to the number of unoccupied crews up to four times, if the average is eight calls and the delay is 4 percent. cases – it seems small, but it is very significant because it is life. Therefore, we would solve practically all problems through new points and through centralization, ”said the deputy minister.
Retractable treatment beds
Based on the proven model of COVID-19 coordination centers, a slight reorganization of the regional network is planned: some municipalities would be assigned to another administrative center.
The higher level hospitals, tertiary, would remain two. Adding the Klaipeda University Hospital was considered, but was deemed to be too costly financially.
According to a model developed by the ministry, by 2030 it will be necessary to reduce around 1,500 active treatment beds from the more than 16,000 that exist.
The goal is also to increase the number of days of active bed use from more than 270 to 300 days a year.
According to this principle, the number of midwifery beds should decrease significantly in Vilnius and Kaunas, and the number of surgical beds should decrease in most regions. According to the deputy minister, most of these reductions are not very significant.
“It is more acute with tuberculosis. The need for TB beds due to the development of outpatient services is quite high, especially in Vilnius and Kaunas, but it is not yet high in Panev aúnžys. We want resistant tuberculosis to be concentrated only in Vilnius, Kaunas and Klaipėda, it is time to change the profile of the Alytus County Tuberculosis Hospital to another institution: long-term care or even social services ”, said D. Jankauskienė.
Currently, according to SAM, it is necessary to develop outpatient psychiatric services, as well as reorganize the network of child development disorders, leaving the centers in Vilnius and Kaunas, and have a network of crisis prevention, outpatient care and rehabilitation in Šiauliai. , Klaipėda and Panevėžys.
Coordinate with partners
After presenting these proposals to the Seimas Health Affairs Committee, coordination with partners will begin and additional working groups will be created to implement some of the reforms.
Coordination of the project with the European Commission will begin in mid-August and is expected to end by the end of the year. In the last quarter of this year, a government resolution on the criteria and concept of networking is expected.
During the fall session, reform-related legislative packages should be presented to the Seimas: the new Laws on ambulances and long-term care, as well as the amended Laws on insurance of health institutions and the health system.
It is also planned to propose modifications to transform the National Cancer Institute from a research institution into a service provider and integrate it into the health system.
The government expects to complete this reform during the period, the first financing for institutions should arrive in the first half of next year.
