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Economic and management Aspects of Health Insurance in the Republic of Moldova


Author: Veronica Idricean
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Year:2006
Scientific adviser: Constantin Eţco
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 15 February, 2006
Approved by NCAA on the 27 April, 2006

Abstract

Adobe PDF document0.41 Mb / in romanian

Thesis

CZU 368.9.06 (043.3)

Adobe PDF document 1.09 Mb / in romanian
124 pages


Keywords

insurer, insured person, contractor, insured case, insurance contract of optional medical insurance, medical institution, program of optional insurance for medical assistance, insurance premium, insured risk, insurance sum, balance of insured sum, validity term

Summary

In the Republic of Moldova, as in the majority of European Union countries, the medical insurances are realized in two forms: compulsory insurance and optional insurance, each of this type having its peculiarities.

The present scientific research is a non-experimental study of descriptive type. In accordance with the size of the sample it was made the integral and selective study. For the first time in the Republic of Moldova is studied the market of optional medical insurances, are estimated the advantages and disadvantages of optional medical insurances, are proposed new programs of coexistence of the optional and compulsory medical insurances.

The detailed study of the volume and quality of the medical services offered through optional medical insurance was made at the International Insurance Company “QBE ASITO” JSC for the period of 2000-2004.

During 2000-2003 years can be noticed an increase of the returns indexes, compensations paid to the insured persons with a further decrease of these indices in 2004 year, fact that is determined by the reform in the domain of health protection by implementing the compulsory medical insurances.

By us it was determined that 80±2,0% (p<0,001) of respondents agree with additional expenses from their own sources for receiving qualitative services and in 10±4,2 % (p<0,05) of cases they agree to conclude a contract for optional medical insurance.

The results of the study that appreciate the share of expenses in the optional medical insurances and the possibility to combine them with the compulsory medical insurances prove that the average age of the persons that possess policies of OMI is 65,0±2,9 years, in 43,3±4,3% (p<0,001) the patients need urgent services, and because of this fact have been hospitalized, in 46,7±4,2% (p<0,001) of cases the patients have been directed in hospitals by the family doctors. Without the direction of the family doctor have appealed 10,0±5,5% (p<0,05) of the patients Employed were only 10,6±5,4% (p<0,05) of the patients. The average length of the treatment was of 5,5 days. By us was determined the average age of the persons insured within OMI which is 45,0±2,1 years. In 90,0±1,8% (p<0,001) the hospitalizations have been scheduled and only in 10,0±5,5 % (p<0,05) the hospitalizations were urgent. As a result of the study are proposed forms of coexistence of CMI with OMI as forms with more stages of the system of medical insurances, and the common program of medical services should form as a program with two levels.

In the paper, by survey method was appreciated the satisfaction of the person insured for medical services obtained through OMI as well as the satisfaction of medical workers within their collaboration with the company that provides OMI.

The prophylactic element applied within the OMI was studied for 2001-2003 years regarding the structure of the pathologies of the persons insured in more organizations. In 2002-2003 in comparison with 2001-2002 years the cases insurances due to the pathologies of cardio-vascular system decreased twice, 1,9 times decreased the cases due to pathologies of respiratory system and 3,8 times increased the cases of accidents and 2,5 times increased the diseases of the osteo-articulary system.

On the basis of the study was elaborated the Technology of offering services to the persons insured through OMI, that is implemented and its influence on the quality of services provided the persons ensured through OMI is evaluated.