Ministry of Health, Labour and Social welfare MontenegroMinistry of Health, Labour and Social welfare Montenegro

HEALTH SYSTEM MONTENEGRO

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.

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

4 KEY PRINCIPLES OF REFORM

1) UNIVERSALITY2) EQUALITY3) ACCESSIBILITY4) QUALITY AND EFFICIENCY

Health policy, which has the aim to carry out health system reform, shall proceed from the following general principles:

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

BASIC CONCEPT OF PRIMARY HEALTH CARE REFORM

The The chosen doctor chosen doctor project is already project is already tested intested in Primary Health care Center Podgorica, and it Primary Health care Center Podgorica, and it isis already already implemented into others parts of our state.implemented into others parts of our state.

1. chosen doctor for adults 2. chosen doctor for children3. 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: 1. continuing education of medical staff on primary health level 2. continuing education of specialists 3. establishing of cathedre for family medicine

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.

DENTISTRY REFORM

Privatization of dentistry service

Chosen dentist, privatiser provides services included in general pocket of services (children up to 18 years old, pregnant women;emergency cases and persons over 65 years old)

Services are provided on contract basis (between Health Insurance Found and chosen dentist)

An electronic citizen’s 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

HEALTH CARE INFORMATION SYSTEM

New health care information system is implemented in order to carry out PHCR

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

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

THANKS FOR YOUR ATTENTION!