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Regional health conference and health care planning: involving the users

Regional health conference and health care planning: involving the users. Dr. Jeanine Pommier. Health/ health determinant Objectives. Plans /programmes of action. National level. Health/ health determinant Objectives. Strategic plan Specific actions. Regional plans Specific actions.

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Regional health conference and health care planning: involving the users

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  1. Regional health conference and health care planning: involving the users Dr. Jeanine Pommier

  2. Health/ health determinant Objectives Plans /programmes of action National level Health/ health determinant Objectives Strategic plan Specific actions Regional plans Specific actions Regional level

  3. Objectives and regional plans of public health • The representative of the State in the regional area, defines the implementation of the objectives and the national plans while taking into account of regional specificities

  4. Objectives and regional plans of public health (PRSP) • regional conference of health (CRS) (regional definition of objectives and evaluation) • regional plan of public health (PRSP) (coordinates pluriannual programs and actions) • regional or territorial grouping of public health (GRSP) (implements PRSP with representative of the State) + other officially agreed organizations • regional council (CR) can define helath objectives particular to the region

  5. Regional level: organization Consultations, dialogues Definition of the objectives, Piloting. development GRSP CA of the GRSP Develop the regional plan of public health Coordination Implementation ARH (Offer care) Region, department, communes Prefect of area (DRASS) *Developping in the region the objectives and national plans *propose the regional plan of public helath *Evaluate the programs of public health • Regional conference of health • Local authorities, • Health insurance • Patients and users • Professionals • Institutions • Regional observatory of health • Regional committees of health education • Qualified personalities. Regional plan of public health Organizations with particular competences INVS URCAM INPES The Regional Council Can define and develop health actions URML

  6. Constitution of regional conference of health (CRS) • representatives of local authorities • Public and private health insurance organizations • patients and users of health system • health professionals • public and private health institutions • regional observatory of health • qualified personalities

  7. Report on the respect of patients rights in Brittany • Respect of the dignity of the patient • Announcement of diagnosis • Respect of the medical secret • Access to care • Geographical, physical, financial, waiting • Right to information • Patient participation on the health system

  8. THÈME 1 : RESPECT of DIGNITY Globaly YES but …

  9. THÈME 1 : RESPECT of DIGNITY • … there are situations lacking respect of dignity : • for elderly, handicaped, deprived • due to lack of intimacy, care in non adapted services (pediatrics), bad conditions in announcing diagnosis

  10. THÈME 2 : acces to medical record In majority YES but …

  11. acces to medical record THÈME 2 : organisation is not sufficient

  12. THÈME 2 : acces to medical record Not many complaints to patient NGOs

  13. THÈME 3 : ACCESS TO HEALTH CARE

  14. THÈME 3 : ACCESS TO HEALTH CARE • Complains concerning : • ( distances,…) • Lack of beds (emergency++, moyen séjour, rééducation, ) • Discrimination of dependent persons and/or handicaped, prisonners, CMU beneficiaries • long waiting lists • Lack of coordination between hospitals and ambulatory care • Physical accessibility

  15. THÈME 3 : ACCESS TO HEALTH CARE Mixed feelings Worse: less gardes et more dépassements d’honoraires et tickets modérateurs,… Better :general health care organisation, developement of specialized éation de consultations, development of home hospitalisation, maisons de garde,…

  16. THÈME 4 : PATIENT REPRÉSENTATION Majority say YES

  17. THÈME 4 : PATIENT REPRÉSENTATION • Globally but but some difficulties exist: • not enough training for patient representatives • not enough people want to be representatives • Difficulties for reimbursement of expenses

  18. Résumé Enquête • Thème 1 : Droit au respect de la dignité : une évolution globalement favorable malgré la persistance de cas particuliers. • Thème 2 : Droit d ’accès au dossier médical : une évolution favorable même si les procédures d’accès au dossier médical restent peu connues. • Thème 3 : Accès aux soins : de fortes inquiétudes relatives à la permanence des soins et à l’accès aux soins pour tous. • Thème 4 : Représentation des usagers: une évolution favorable mais la question du défraiement reste posée.

  19. Main results • Globally getting better since 2002 • Persisting problems: • Access to health care from every perspective (geographical, financial, physical) • Respect of the rights of poor and/or fragile populations

  20. Proposals • Training/empowerment of health professionals concerning patients rights to information, access to health care, patient/doctor relationship • Plans against discrimination • Role of associations

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