Ogurcova, Ilona

The efficiency and quality of healthcare services increasingly depend on the application of advanced governance, risk management, and control models. Internal audit, when conducted in line with international professional standards, has the potential to act not only as a control mechanism but also as a strategic partner contributing to organizational resilience and value creation. In 2024, The Institute of Internal Auditors (IIA) introduced the Global Internal Audit Standards, strengthening the emphasis on professionalism, independence, competence, and strategic alignment of the internal audit function across all sectors, including the public healthcare system. This article examines the challenges of applying these global standards within the Lithuanian healthcare sector, focusing on a specific regulatory requirement that mandates medical or health sciences education for the head of internal audit (the so-called internal medical audit). Through a systematic analysis of the Global Internal Audit Standards, national legislation on public sector internal audit, and sector-specific regulations issued by the Ministry of Health, the study identifies a fundamental normative tension between international audit professionalism and sectoral qualification restrictions. The article argues that internal audit effectiveness derives primarily from professional audit competencies, independence, and risk-based methodologies rather than from subject-specific clinical education. Drawing on an analogy with information technology audits, the analysis demonstrates that complex, knowledge-intensive sectors can be audited effectively through professional internal auditors who engage subject matter experts without compromising objectivity. The findings suggest that the current regulatory model risks professional isolation of healthcare auditors, reduced audit value, weakened organizational resilience, and inefficient allocation of scarce healthcare resources. The article concludes that aligning national healthcare audit regulation with the Global Internal Audit Standards would strengthen governance, enhance risk management, and enable internal audit to function as an integral component of professional management and innovation within healthcare institutions.

Reabilitacija po traumos ar operacijos dažnai suvokiama kaip savaime suprantamas sveikimo etapas, tačiau praktikoje šis kelias ne visada būna sklandus. Daugeliui žmonių reabilitacija prasideda ne tada, kai jos labiausiai reikia, o tada, kai pavyksta „prasimušti“ per skirtingų institucijų, siuntimų ir vertinimų grandinę. Būtent ši spraga tarp sveikatos ir socialinių paslaugų šiandien vis dažniau tampa ne tik nepatogumo, bet ir pavėluoto sveikimo priežastimi.

This study explores how patients drive meaningful changes in healthcare, focusing on accessibility, satisfaction, and service delivery through inclusive and interdisciplinary perspectives. Conducted in 2024, it analyzes healthcare trends from 2021 to 2024, emphasizing patient participation in decision-making. This sociological study highlights the interplay between healthcare accessibility and patient satisfaction within the broader framework of inclusive and interdisciplinary innovation. Findings reveal that while 99% of the population relies on primary care, barriers persist in accessing specialist services and navigating the doctor registration system. Reports of accessibility and quality issues increased from 30% in 2021 to 48% in 2024 due to organizational shifts, leading 29% of patients to seek private care to avoid long wait times. Healthcare utilization rebounded, with service visits rising from 23 million in 2020 to 28 million in 2023, exceeding pre-pandemic levels. Primary care, diagnostics, and specialist consultations dominate service use, while mental health, rehabilitation, and nursing remain underutilized. Emergency services serve nearly half the population, yet only 64% rate secondary care positively, exposing quality gaps. The study advocates for patient-centred reforms, reducing bureaucracy, enhancing accessibility, and fostering institutional collaboration. Structural investments are essential for sustainability, as private healthcare provides only temporary relief. By emphasizing patients’ roles in shaping healthcare policy, this research contributes to social innovation discourse. It challenges traditional paradigms by advocating a model where patient feedback and participation drive reform, aligning with SOCIN’s vision of inclusive, interdisciplinary, and impactful healthcare innovations.

Šiame straipsnyje pristatomos 2024 metais atlikto reprezentatyvaus sociologinio tyrimo apie pacientų elgesį, įpročius, lūkesčius ir pasirinkimus Lietuvos nacionalinėje sveikatos priežiūros sistemoje (LNSS) išvados. Tyrimo tikslas – suprasti, kaip asmenys suvokia sveikatos priežiūros paslaugų prieinamumą ir organizavimą reformų ir popandeminių iššūkių kontekste. Išvados rodo, kad dauguma gyventojų, per pastaruosius trejus metus naudojęsi sveikatos priežiūros paslaugomis, susidūrė su problemomis, ypač COVID-19 pandemijos metu. Pirminė sveikatos priežiūra yra patikimiausia, tačiau antrinėje ambulatorinėje priežiūroje kyla daug kliūčių. Tyrimas pabrėžia, jog tenkinant pacientų poreikius reikia geriau koordinuotų, skaidresnių ir labiau integruotų paslaugų. Reikšminiai žodžiai: pacientų elgsena, gyvenimo eigos sveikata, sveikatos politikos formavimas, pacientų įtraukimas, socialinių ryšių poveikis sveikatai. .

Straipsnyje analizuojami dviejų reprezentatyvių Lietuvos visuomenės nuomonės apie sveikatos priežiūros paslaugų (SPP) kokybę ir prieinamumą tyrimų rezultatai ir jų pokytis per 10 metų. Atskleidžiama, kaip buvo įgyvendinama SPP kokybės politika ir kuriama vertė pacientui, taip pat aiškinamasi, kaip ji veikia SPP kokybę.

It has been concluded that the essential criterion for evaluation of effective TAP use is personal energy commitment. This is to say that a person using different products of the same type to perform the same kind of action commits a different amount of energy because of product design peculiarities and choice of accessories. In other words, several TAP are offered to a person after assessing their everyday needs and impairments. The TAP that is the most suitable for the person is the one using which they commit the least amount of energy. Currently, the CTAPD and DWCAO (Disability and Working Capacity Assessment Office), using the International Statistical Classification of Diseases and Related Health Problems (ICD) and International Classification of Functioning, Disability and Health (ICF), are working on functional ability identification tests that could be used to determine energy commitments when using this or that TAP.