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Scientific argumentation of the strategic directions of the development of the average-term health system


Author: Golovin Boris
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Year:2010
Scientific adviser: Mihail Ciocanu
doctor habilitat, associate professor (docent), State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution: State University of Medicine and Pharmacy "Nicolae Testemitanu"
Scientific council: DH 50-14.00.33
State University of Medicine and Pharmacy "Nicolae Testemitanu"

Status

The thesis was presented on the 17 November, 2010
Approved by NCAA on the 23 December, 2010

Abstract

Adobe PDF document0.38 Mb / in romanian

Keywords

health system, strategic direction of development, institutional capacities, informative system, the efficiency of the medical services, the quality of the medical assistance.

Summary

Thesis structure. The thesis comprises the introduction, four chapters, general conclusions and recommendations, bibliography from 145 titles, 11 attachments, 130 basic text pages, 23 figures, 21 tables. The achieved results are published in 14 scientific works.

The thesis field of study is the analysis of the existing problems in the health system and the elaboration of recommendations on the basis of the scientific proofs for the amelioration of the medical assistance efficiency and quality.

Purpose of the research is the scientific analysis of the processes that influence the health system and that can improve the routing functions, the financing, and the provision of the services and of the resources’ generation concerning the argumentation of the directions of the development of the average-term health system.

Research objectives: evaluation of the institutional capacities of the decisional structures from the health system, the analysis of the basic components of the health national informative system (HNIS), the evaluation of the efficiency and quality of the medical assistance at different stages of the services’ provision, the argumentation of the strategic directions of the development of the health system for an average-term and of the basic interventions for the quality programs. Scientific novelty and originality of the investigation consists of the initial research of the institutional capacities of the central decision body from the health system and of the subordinate institutions, of the quality of the monitoring and patients’ treatment processes. For the first time in the Republic of Moldova have been studied the prices for a production unit in the medical institutions in order to prove the necessity of the expenses and medical infrastructure optimization. Based on a very original methodology there has been evaluated the health national informative system. This evaluation allowed us to identify the quality of the resources, of the indicators, data bases and of the management of the informative system.

Theoretical significance and the applicative value of the work comprises the analysis and the descriptions of the rules that characterize the health and which can be influenced positively through management interventions of the medical services and of the participative mobilization of the community. There have been identified the reciprocity relations between the quality of the medical services and the population mortality due to various diseases. There has been proved the necessity of the implementation of the continuous evaluation tool of the prices for a production unit that can improve the contracting and reimbursement process of the medical institutions.

Implementation of the scientific results. The results of the research have been used at the elaboration the “Strategy of the development of the health system in the period 2008 – 2017”, of the Institutional Development Plan of the Ministry of Health, of the Strategic Development Plan of the health national informative system, of the Order of the Ministry of Health nr. 502 from December 25, 2008 “Regarding the organization of the geriatric medical assistance in the Republic of Moldova”, of the Order of the Ministry of Health nr. 333 from August 19, 2008 “Regarding the organization of the medical treatment at home”, of the Project of the “Concept of the management system of the quality in the health system”. The results of the study serve as didactic material for university and post-university teaching of the medical staff.