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CNAA / Theses / 2009 / June /

Management and Economic aspects in the organization of medical help to rural population

Author: Paun Grigore
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Scientific adviser: Constantin Eţco
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific council:


The thesis was presented on the 24 June, 2009
Approved by NCAA on the 1 October, 2009


Adobe PDF document0.30 Mb / in romanian


rural populations, birth-rate, morbidity, morbidness, death reasons, invalidity, providing of population with medical staff, medical institutions providing, staff management, financial management


Our scientific research is dedicated to analysis of Public Health reforms and their results. For the first time in the Republic of Moldova it was fulfilled the detail analysis of situation before and after reforming in the Public Health at the economic, social and medical levels in the period of 1997-2007 years. We have analyzed 3 statistic groups and the dynamics of indicators of public health level, as well as the activity of medical institutions.

The researches were directed to the defining of demographic processes, the level and structure of morbidity, the providing with medical staff, different economic indicators and medical institutions financing. There were studied more than 277 original sources, the experience of other scientists, working in the field of Public Health Management and reforming of medical aid organization and medical services financing.

The results of study such demographic processes as the structure of population birth-rate, general age indicator of mortality, the structure of mortality according to the reasons of mortality, infant mortality, natural growth of population etc. proved that our demographic situation is characterized by negative tendencies and Public Health reforms has not stopped these tendencies.

According to all available data of the level and structure of morbidity such as general morbidity, morbidness etc., - have increased during the last years and proved the negative tendencies in the demographic situation, the level of accumulating morbidity has increased, as well as the number of patients with chronic diseases and growth of temporary disablement and invalidity.

The analysis of providing of population with medical personnel has proved the decreasing of this indicator. The possible reason may be the shortage moral and material motivation of work in the sphere of Public Health.

The financial management study has proved the improvement of financing of medical institutions since medical insurance introduction, but this situation has not stimulated the medical activity improvement.

According to the results of our researches we have made conclusions and practical recommendations for actual moment and perspective in the field of Public Health institutions improvement.