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Hospital financing in the conditions of the implementation of Compulsory Health Insurances

Author: Ghenadie Damaşcan
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 14 September, 2005
Approved by NCAA on the 27 October, 2005


Adobe PDF document0.26 Mb / in romanian


For the first time, based on a polivalent analysis of the activity in the conditions of compulsory health insurances in the Republic of Moldova, there was elaborated:

- a complex of measures concerning the optimisation of hospital medical assistance payment mechanisms;

- several new principles of calculating the costs per case treated;

- some new principles of distributing the activity volume between hospital medical services providers;

- several new principles of hospital contracting.

In this thesis there were analysed payment methods for hospital medical assistance, there were also studied problems concerning medical institutions financing (applied by both medical services provider and the buyer), occured during the first year of activity of hospitals in the conditions of Compulsory Health Insurances.

There where studied the number of cases treated by different level medical institutions, the accomplishment of the contracted number of cases treated by hospitals, the influence of the accomplishment of case treated number on the average lasting of the treatment, the number of invalid cases treated, the tendences for modifying contractual agreements, etc.

A special chapter of this thesis is dedicated to the study of cases treated groups forming modalities. There was proposed a new model of cases treated groups forming, based on dividing in groups that resemble in medical cares costs.

The attention has been drawn upon the examination of financing tacties for cases treated at an exceptional cost. There was proposed the possibility of forming groups of cases treated at an individual cost, the criteria for their defining and treatment cost evaluation modality.

As a conclusion of this thesis there were placed under disscusion the problems of contracting hospitals.

There were also proposed mechanisms of stimulants reduction for overcoming contracted hospital services numbers.