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Management of nationаl transplant system


Author: Codreanu Igor
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Year:2016
Scientific adviser: Oleg Lozan
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Adrian Tănase
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 3 February, 2016
Approved by NCAA on the 21 April, 2016

Abstract

Adobe PDF document – 1.35 Mb / in romanian

Thesis

CZU 614.2: 616-089.843

Adobe PDF document 5.03 Mb / in romanian
175 pages

Keywords

donor, organs, tissues, cells, legislation, the national transplant system, the automated information system, medical workers, public opinion poll

Summary

The framework. The thesis is written on 175 pages, contains the introduction, 4 chapters, conclusions, recommendations, 134 pages of basic text. Abstracts are presented in Romanian, English and Russian. Bibliography includes 184 references. The thesis includes 49 figures, 30 tables and 7 appendices. The results were published in 23 scientific works, including in the international journals. In 3 publications author presents the material like the only author. 17 articles are published in reviewed editions.

Field of Study. Social Medicine and Management.

The goal of the research. Scientific argumentation of the organization and strategy of the development of the transplant system for effective function and high-quality transplant services.

The objectives: to study the organization of the european transplant systems; the evaluation of tendencies and influence on national system. Development of the methodological principles of organization and functioning of the national transplant system. Assessing the feasibility of the legislation on the basis of international and national experiences, identification of the optimal strategies of development. The elaboration and implementation of the automated information system ”Transplant” with the aim of monitoring the donation activities in the all regions of Moldova. Evaluation of knowledge and skills of medical personnel in the transplant services. Evaluation of knowledge of population relating the transplant system. Analysis and justification of the strategic directions of the transplant system organization.

Research novelty. For the first time in Moldova the comprehensive interdisciplinary study of transplant system is made. Management of the system is studied as a part of integrated system of public services, including the social, medical and legal assistance. There were analysed the options that would allow an improvement in the organization and functioning of the transplant system, including changes in the law, allocation of financial and human resources, quality assurance and safety of transplant procedures. The scientific problems resolved consists in the analysis of the organisational models of transplant systems and scientific argumentation of the development of the strategic directions of the National Transplant System to ensure efficient functioning of the services provided to the population.

Theoretical value of the research. There were presented the evidence, arguments and results, which prove the social, medical and economical efficiency of development of the transplant system in the Republic of Moldova. The priorities in the organization, legal framework, training of medical staff were set up. The achievements and reserves in promotion of donation for the general population have been exposed.

The applied value. The scientific evidence might be used to improve the Law nr. 42-XVI/06.03.2008 and for development of the new legislation by the Parliament, the Government and the Ministry of Health. The results of research may serve as a basis for the development of the National Transplant Program. The exposed facts may be used by medical providers for the staff development and the transplant services improvements.

Implementation. The strategic approach to the organization and management of the national transplant system developed. The modifications to the Transplant Law prepared. The results of research are used for the development of the National Transplant Program. The implementation of the automated information system ”Transplant” allowed the connection of all the authorised medical providers in a network and monitoring of the procurement, codification, conservation and distribution of the organs and tissues in the on-line system.