Transcript My practice-Challenges in Romanian rural health care

My practice-Challenges in Romanian rural
health care- meeting the needs of the
community
The National context
•Approx. 11400 GPs working in mostly solo practices
•Nr. of patients/GP 1545,practice nurse/GP rate1.2
•GPs are the owners of the practice-their contract is renewed periodically
•Nr. of settlements without any health care provider 88, with a total of 153904
inhabitants
•Percentage of people without health insurance 16.10%
•Amongst EU states Romania has the most reduced percentage of GDP
spent on health care- 5.5%
Facts
• contracted GP services
• fees:capitation and service
• electronic prescriptions,implementation of electronic health
records
• screening programmes-very limited
What to improve?
•no existing clear national policies to address socio-economic
determinants of health: reduced access to health care, lack of
local health services, poverty
•No feasible solutions are offered to bridge the gap between
sporadic and continuous access to health care services
•The social care network is fragile, GP practices are the only one
easily accessible health care providers in the rural communities
•Local primary care team can play a key role in offering tailored
health services in the community,in building partnerships
between different health service providers in the community
Our intervention
•Our health centre is located in the north-western
region of Romania
•We provide the community with the possibility
of having ultrasound, ECG examinations, lab
tests, physiotherapy, family planning services and
access to prevention programs performed locally
•During the years we developed educational
programs targeting different groups in the
community, have done research activities to gather
evidences in order to prove the importance of our
activities
•The activities are ongoing and continuity helped
developing partnership with the community
Our intervention
•Integrated local health service delivery and multidisciplinary team
work aimed to increase participation and meet the needs of the
target population
•Pro-active approach exploring concerns and expectations
•With the primary care team as a core structure and coordinator,
supported by local NGO and authorities basic health services,
population screening and educational programs are accessible in
the community
•Local and ongoing, reliable service delivery with no unexpected
interruptions - necessity in building partnership and gaining
credibility
Our results
• Our approach of local service delivery in the community has helped to
improve the relationship between our staff and the deserved population :
trust has lowered the threshold for contact
• The service must be ongoing and reliable to increase participation
• The model is sustainable as it uses local resources and is based on a
partnership with the community
• The population must be a partner in reducing health inequalities