strategic objectives of the georgian health system
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New Vision For Better Health. Strategic Objectives of the Georgian Health System. MEDEA 2011 Ministry of Labor Health and Social Affairs. New Infrastructure New Opportunities for Professional Development New Standards for Medical Activity and Case Management New Model of Health Financing - PowerPoint PPT PresentationTRANSCRIPT
Strategic Objectives of the Georgian Health System
New Vision For Better Health
MEDEA 2011
Ministry of Labor Health and Social Affairs
New Infrastructure New Opportunities for Professional Development New Standards for Medical Activity and Case
Management New Model of Health Financing E-Health - MHIS & EMR New Regulations for Medical and Pharmaceutical
Services Strengthening MEDIATION services New Public Communication Strategy
New Infrastructure
Hospital Sector Reform- More then 1 billion USD to be invested in new
Infrustructure - Up to 150 new health facilities will be
constructed/renovated and equiped- Public-Private Partnership in Service Delivery
Tbilisi 37
Samegrelo
8
Kvemo-Kartli7
Kakheti8
Svaneti3
Abkhazia
Ajara9
Guria3
Imereti15
Mckheta-Mtianeti
5Shida kartli
5
Samckhe-Javakheti7
Racha-
Lechkhumi
2
New Infrastructure
New InfrastructureUpdating Public Health Infrastructure- USA-Georgia Partnership: DTRA project - 11
advanced new Public Health Laboratories, integrated surveillance system
- Mental Health Facilities: MH departments integrated in General Hospitals, new facilities for long- term Care, Community based outpatient clinics
- Infectious Diseases: New National TB, HIV/AIDS and Infectious Disease Centers
New Infrastructure
Throughout the
countryDecember 2011 – 90 new facilitiesApril 2012 – 7 new facilities2013 – rest of the projects
More than 8000 new bed capacity in total
Short-term objectives – be prepared for 2012- Defining list of Priority Medical Specialties - Re-certification of Health Professionals- “Mini residency” programs
New Opportunities for Professional Development
Priority Medical Specialties for new medium and small size (<50 beds) general hospitals and PHC centers- Nurses -
Anesthesiologists- Hospitalists -
Pediatricians- Family Doctors -
Ob/Gyn- Emergency Physicians - General
Surgeons
New Opportunities for Professional Development
Re-certification of existing Medical Professionals - Introducing board certification procedures –
establishing Boards of Priority Specialties- Inviting Georgian doctors and nurses from USA and
Western Europe into the process of re-certification- Start Re-certification of doctors and nurses October
2011
New Opportunities for Professional Development
“Mini Residency” programs and ToTs- USA-Georgia Partnership: USAID project on mini-
residency program for Emergency Physicians – existing know-how
- Training for trainers in priority specialties – creating pool of trainers
- Spreading the knowledge – continuous on the job training
New Opportunities for Professional Development
Long-term objective- Establishment of advanced residency program in
collaboration with international medical universities- Clinical base for residency program – linking with
private multi-profile hospitals- Trilateral cooperation – Government, University,
Hospital
New Opportunities for Professional Development
New Standards Updated standards for medical facilities- December 2010 – amendments in Georgian
legislation on “Licensing” and “Healthcare” – introduction of new licensing requirements for hospitals, PHC facilities and diagnostic centers
- All new health institutions are being created in accordance to the new regulations
- All medical institutions will have to re-obtain licenses according to new regulations after December 31st 2011
New Standards
Strengthening system of standardized care- MLHSA, World Bank and UK National Institute of
Clinical Excellence (NICE) –manual for creation of national clinical guidelines and protocols
- Special emphasis on implementation of existing national guidelines – quality control, costing
- Translation and adaptation of international guidelines
Total Health Expenditure
522 651 725 836 998 1160 1 387 1 661 1 819
7,8%
8,7%8,5% 8,5% 8,6%
8,4%8,2%
8,7%
10,1%
0200400600800
1 0001 2001 4001 6001 8002 000
2001 2002 2003 2004 2005 2006 2007 2008 2009
ჯ ანდაცვაზ ემთლიანი დანახარჯ ები , მლნ. ლარიჯ ანდაცვაზ ემთლიანი დანახარჯ ებისწილი მშპ-დან
New Model of Health Financing
Total Health Expenditure mln. GELTotal Health Expenditure as part of GDP
Structure of Total Health Expenditure
2001 2002 2003 2004 2005 2006 2007 2008 20090%
10%20%30%40%50%60%70%80%90%
100%
14% 14% 15% 16% 20% 22% 18% 21% 23%
77% 74% 78% 78% 78% 73% 72% 69% 71%
9% 12% 7% 6% 3% 5% 9% 10% 6%
საერთაშორისო დახმარება კერძო სახელმწიფო
New Model of Health Financing
International aid Private Public
Trends in Public Health Expenditure
75 88 109 130 196 255 256 343 419
1,1% 1,2% 1,3% 1,3%
1,7%1,8%
1,5%
1,8%
2,3%
0
50
100
150
200
250
300
350
400
450
500
2001 2002 2003 2004 2005 2006 2007 2008 2009
ჯ ანდაცვაზ ესახელმწიფოდანახარჯ ები (მლნ. ლარი)
ჯ ანდაცვაზ ესახელმწიფოდანახარჯ ებისწილი მშპ-დან
New Model of Health Financing
Public Health Expenditure mln. GEL
Public Health Expenditure as part of GDP
Administration of state vertical programs
2007 2008 20090%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
3%21%
45%
96%78%
53%
1% 1% 2%
ვერტიკალური პროგრამები( . პრევენცია და საზ
) ჯანდაცვა ვერტიკალური პროგრამები
( პაციენტზე) ორიენტირებული
სახელმწიფოს მიერ დაფინანსებული
სადაზღვევო სქემები
New Model of Health Financing
Vertical programsprevention
Vertical programsindividual health
State funded privateinsurance
Insurance System Development Progress
Insurance Program for People Under Poverty Line
(120,000 piloted in two regions) Annual premium $ 52
Insurance Program for People Under Poverty Line ( 750,000
countrywide)Annual premium $ 89
Insurance Program for People Under Poverty Line (950,000 countrywide). Voluntary (state subsidized) insurance
(120,000 countrywide)Annual premium $ 108
2007
2008
2009
2007 2008 2009 2010
Budget in US$ 22,305,000 53,988,000 79,079,000 100,669,000
E-Health - MHIS & EMR
Data Repository
Prescriptions
Financial/Billing
EMR/Clinical
E-Health - MHIS & EMR
E-Health - MHIS & EMR
2010 – SIMS development2011 January – electronic birth and death
certificates2011 March – new system of international
classificators2012 – direct electronic data exchange
between providers and MLHSA
New regulations for Pharmaceutical industry
“Recognition” registration mechanism for OECD/EU/FDA approved products
Parallel import mechanism – only notice regime applied
Amendments in legislation – “conflict of interests”
– “Open door” strategy for population – regional branches of MLHSA, local government, service providers from October 2010
– Media campaign from December 1st 2010
– Mediation between service providers and insurance companies from September 2010
Strengthening MEDIATOR services
New public communication strategy
MLHSA and WB joint project on public communication:- Introducing health reform- Promoting health insurance- Re-establishing links with Georgian health
communities abroad
First time in state health programs – public communication costs for Safe Blood, Immunization and Onco-screening programs
Our proposals to US based Georgian health community:
Time to invest in health infrastructureTime to invest in human capital developmentWe offer direct line to the minister and his
deputiesGreen light to your initiatives and projects Joint efforts for better health in Georgia