Ambulatorinių sveikatos priežiūros paslaugų kontrolės užtikrinimas

Abstract

Ambulant (secondary) health care is the chain of health care, where specialized (secondary level) consultations of doctors specialists are rendered. In Lithuanian national health system we can mark three models (types) of institutions which render ambulant health care services, depending on organization of services and type of ownership. These institutions are: municipality clinics, rendering primary and secondary health care services (mixed institutions), municipality centres of primary health care (municipality institutions of primary health care) and private institutions of primary health care (independent contractors). This research is a way to name problems, which emerge seeking to control mixed institutions, rendering (secondary level) health care services. The aim of work: to analyse control problems of rendering ambulant health care services and propose possible ways of solutions. Methodology: to analyse ambulant services, rendered by secondary level doctors otorinolaringolists in the period 2006-01-01 – 2006-01-31, equivalence of these services to law acts and validity of tender to discharge them from the budget of compulsory health insurance allocation. Informational system data SVEIDRA of State patient fund and primary medicine documentary were analysed. Research involved three institutions (mixed clinics), rendering primary and secondary ambulant health care services in Vilnius city. These clinics had contracts with State patient fund. All chosen clinics were similar according the structure of prescribed residents. Services, rendered by secondary level doctors-otorinolaringolists and asked State patient fund to pay of compulsory health insurance budget allocation were evaluated in the research. Results: 36% - 63% secondary level services of doctors otorinolaringolists in three mixed clinics of Vilnius city were given Vilnius territory patient fund for payment not exceeding the requirements form primary health care services. Issues: Current law acts, which regulate rendering of health care services, do not embody assumption for sufficient control of ambulant health care services rendering because not all requirements of services rendering are described. Especially lack of description of requirements, rendering ambulant health care services, is seen. Quantitative control of health care services rendering do not raise serious problems because the forms of statistical accounting documents are confirmed. But control of health care services rendering is pressed till now. Also there is lack of knowledge in the health care services quality security in health care services institutions.