Ministry of Health, Labour and Social welfare Montenegro

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HEALTH SYSTEM MONTENEGRO

• 
  
• Ministry of Health, Labour and Social welfare
  
  Montenegro

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THE MINISTRY OF HEALTH FOR THE OF MONTENEGRO HAVE
PASSED ON THE HEALTH DEVELOPMENT STRATEGY ON
SEPTEMBER OF 2003

• Strategy defines the elements of planning
  activities,
• which shall be carried out in the health
  system, with the
• aim to undertake political, economic,
  social, scientific,
• expert, management, and legislative
  measures to reform
• the health system.
• The strategy for health reform opens up the
  process of
• necessary reform to the health system in
  Montenegro,
• which shall provide better quality health
  care, improve
• health and improve the state of health of
  the population.

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4 KEY PRINCIPLES OF REFORM
Health policy, which has the aim to carry out
health system reform, shall proceed from the
following general principles

• UNIVERSALITY
• EQUALITY
• ACCESSIBILITY
• QUALITY AND EFFICIENCY

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THE HEALTH DEVELOPMENT PROJECT (2004-2008)

• Health development Project is a base of Primary
  Health care reform (financed by World bank and
  CIDA)
• First step - Establishing of legal frame for
  carrying out Primary Health care reform

PASSED SO FAR
TO BE PASSED

• Health care Law
• Health care insurance Law
• Compulsory records in the field of health care
• Law on Medicines and
• Law on medicinal products

• The Law on patient rights
• The law on health care
• The law on transplantation
• The law on assistant reproductive tehnologies
• The law on genetic privacy
• The law on taking of biological samples

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BASIC CONCEPT OF PRIMARY HEALTH CARE REFORM

• The chosen doctor project is already tested in
  Primary Health care Center Podgorica, and it is
  already implemented into others parts of our
  state.
• chosen doctor for adults
• chosen doctor for children
• chosen doctor for women
• It is espected that chosen doctor activities
  should take health care of 80 of diseases
• Primary Health care Center is becoming the
  center of support for the chosen doctor
  activities
• Standards and regulations regarding to
  work of chosen doctor
• Primary Health care Centers are supplied by
  equpment according to needs of the reform
• Reconstruction and adaptation of Primary
  Health care Centers
• Education of medical staff is organised
  trough three levels of education
• continuing education of medical staff on primary
  health level
• continuing education of specialists
• establishing of cathedre for family medicine

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NEW MODEL OF GOVERNANCE AND FINANCING ON PRIMARY
LEVEL OF HEALTH CARE

• New role of managing health care institution on
  primary level (strenghtening of administrative
  capaticies trough advanced level of education -
  CIDA Project)
• The new method for payment of primary health care
  is established - combination per capita payment
  and payment for services provided by chosen
  doctor.
• This kind of payment will start from January
  2009.

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DENTISTRY REFORM

• Privatization of dentistry service
• Chosen dentist, privatiser provides services
  included in general pocket of services (children
  up to 18 years old, pregnant womenemergency
  cases and persons over 65 years old)
• Services are provided on contract basis (between
  Health Insurance Found and chosen dentist)

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HEALTH CARE INFORMATION SYSTEM
New health care information system is implemented
in order to carry out PHCR

• An electronic citizens health card is
  established as a central element for medical
  documentation
• Integrated Health information system is
  established in order to support Primary Health
  Care reform
• Each citizen will have his own electronic card
  which will keep certain data about each user,
  thus contributing the improvement of health
  services quality
• Enable access to data by different participants
  in the health system according to the defined
  levels of access.
• Including of electronic invoice which will be
  sent to Public Health Institute and Ministry of
  Health, Labour and Social Welfare

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FURTHER STEPS OF HEALTH CARE REFORM

• All activities regarding primary health care
  reform are going to be finished by the end of
  2008.
• present problems on secondary and tertiary
  health care level
• Lack of separation between secondary and
  tertiary health care
• Lack of efficiency
• Irracional and uncontrolled drug consumption and
  lack of system control
• Unefficient health care institution managing
• Inadequate mechanism of providing health care
  services

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FURTHER STEPS OF HEALTH CARE REFORM

• TASKS
• Establishing of standards and regulations
  regarding providing of health services
• Establishing General Pocket of services,
• creating of clinical protocols and guidelines
• Implementation of new payment method
• Establishing of Health institution network
• WE ARE AWARE THAT
• This is very complex and long term process which
  depends on social and economic development,
• Expiriences of other countries are a very
  prescious help for us, but nevertheless every
  country is supposed to chose an adequate model of
  reform
• The Health system undergoes constant changes, so
  we will try to adopt and include all the needed
  steps in order to provide better health service
  for our citizens

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THANKS FOR YOUR ATTENTION!