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“As we can see, within a month, approximately half of the institutions report that they can activate the provision of services. And yet, as he correctly mentioned, the situation is tragic, the fact that he has presented plans does not mean that he has already I have activated the services. Oh, if it has been activated, it is still difficult for us to decide … how much these services are actually provided, “said L. Jaruševičien in in response to the observation of the Member of Seimas.
The Vice Minister assured that the Ministry listens to complaints from patients that it is very difficult to obtain a consultation, to get to the doctor. A spokeswoman for the Ministry of Health hinted that this situation forces us to rethink promises about funding institutions.
During the quarantine, when the provision of scheduled services was suspended, the Ministry of Health assured the institutions that they would not suffer in any way, since they would be paid one twelfth of the contractual amount with the funds of the territorial health insurance.
“Now there is an option: on the one hand, the security of the institutions, which means that they receive a twelfth and cannot provide (or provide very few) services, because a twelfth is guaranteed. And we have patients with their health care needs A balance needs to be struck between these extremes, probably none of the twelfths will fit, and the old service finance model probably won’t anymore.
What that model will be is still difficult to say. We are thinking about it very intensely, because the fact that time plans have been prepared in only half of the institutions per month is very worrying, ”said L. Jaruševičienė.
After two weeks, institutions can increase the scope of services.
The Vice Minister recalled that a state of emergency was declared on February 27. , but changes in service provision occurred only after quarantine was announced (March 16). Throughout the quarantine, necessary and emergency care, group services, oncology, and planned vaccinations were uninterrupted.
“But the provision of specialized outpatient services and hospitalization were very severely restricted,” said L. Jaruševičienė.
According to the vice minister, a month and a half later, on April 29, the requirements to resume the delivery of scheduled services were approved by a decision of the operations manager. May 18 Requirements for renewal of scheduled dental services were approved.
“Institutions can already make plans and start updating services. Initially, it was recommended to start with 50 percent. The maximum safe number of patients and increase it to 100% in a two-week period,” said L. Jaruševičienė.
Most of the services were provided remotely.
The Vice Minister introduced that in the period from mid-March to the end of April, COVID 19 patients with suspected or suspected patients received a wide range of services, while the situation was different for other patients.
The Vice Minister compared the situation with the same in 2019. period. According to L. Jaruševičienė, in primary health care, most services were delivered remotely through quarantine, but the number of services provided was 20%. less than in the same period last year.
“If we look at specialty outpatient services, the decline was more than 86 percent. It was exactly the same with prevention programs. The number of incentive services and day hospitals has decreased dramatically. The volume of outpatient services Emergency reception also decreased by about 40%. Surveillance services are similar. Day surgery was almost non-existent. About 50 percent. The number of active inpatient treatment services decreased, “L. Jaruševičienė said.
According to the deputy minister, expensive exams have been cut in half, with a sharp decline in outpatient care at home. 10% provided institutional nursing and supportive care services. less, and hospice services provided 3 percent. plus.
Significant changes are observed compared to the same period last year in the area of emergency aid.
“We see that the range of specialized outpatient emergency care services has been halved, emergency reception care and monitoring, by more than 40%, from emergency care to almost 40%. Reduction of hospital treatment active “, – said L. Jaruševičienė.
So-called cluster services were also less common.
“With myocardial infarction, we see less than 30 percent. Stroke: a quarter when thrombolysis is applied, but we have almost 16 percent. Greater number of services when invasive thrombectomy was performed. This may be related not so much to COVID-19, but rather with changes in the description of the stroke, ”said L. Jaruševičienė.
The Vice Minister reported that the use of the digital health system has increased significantly. Among other things, the use of the system, where doctors themselves verify drug interactions, increased in March and April.
The mortality situation is not dramatic.
The Vice Minister of Health reported that Lithuania, based on international methodologies, is actively monitoring mortality rates (not just from coronaviruses).
“All countries monitor the situation according to the same methodology. Here are the death rates for France, Sweden and Austria. We see that the indicators for Austria are closer to Lithuania, although they seem to be better. (…) Without However, both Sweden and France have higher figures.
In other countries, there has been an increase in deaths where treatment for another cause is treated, but this may be a latent case of COVID-19. (…) Our curve to mid-May does not show these figures, which allows us to assume that the situation so far is not as dramatic as could have been imagined, and that we were all very concerned, “said L. Jaruševičienė.
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