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REPUBLIC OF MACEDONIA HEALTH SYSTEM -OVERVIEW AND CHALLENGES- Minister of Health Bujar Osmani, MD

REPUBLIC OF MACEDONIA HEALTH SYSTEM -OVERVIEW AND CHALLENGES- Minister of Health Bujar Osmani, MD SEECP Health Ministerial Meeting “Achievements and challenges of strengthening health system performance through addressing inequalities in health services in South Eastern Europe”

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REPUBLIC OF MACEDONIA HEALTH SYSTEM -OVERVIEW AND CHALLENGES- Minister of Health Bujar Osmani, MD

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  1. REPUBLIC OF MACEDONIA HEALTH SYSTEM -OVERVIEW AND CHALLENGES- Minister of Health Bujar Osmani, MD SEECP Health Ministerial Meeting “Achievements and challenges of strengthening health system performance through addressing inequalities in health services in South Eastern Europe” Chisinau, 7 November, 2008

  2. Population: 2,036,855 Administrative division: 84 municipalities Capital: Skopje Ethnicity/languages: Macedonian 64,18%, Albanian 25,17%, Turkish 4%, Roma 2%,Serb 2%, Vlachos 2%, Other 1% Religions: Orthodox Christian 67%, Muslims 30% Literacy rate: 94% Unemployment rate: 37% GDP per capita: $ 2200 Health expenditure of GDP: 6 % Socio Economic Indicators

  3. Health System Organization

  4. Number of inhabitants per 1 Doctor by health regions in Republic of Macedonia in 2006

  5. Number of inhabitants per 1 Dentist by health regions in Republic of Macedonia in 2006

  6. Health Indicators • Life expectancy at birth: 73.4 • Natality - rate per 1000: 11.0 • Infant mortality rate: 12.8 • Maternal death per 100,000 live births: 11.0 • Mortality rate – per 1000: 9.0

  7. The Distribution of Leading Causes for Death • circulatory diseases 599,1 /per 100 000 • malignant neoplasms 265,1 /per 100 000 • respiratory diseases 41,6 /per 100 000 • injuries 32,9/per 100 000

  8. Priorities of the Health System Reforms • Improving health status • Efficacy of the health system • Providing quality of services • Strengthening public health • Planning of the human resources • Providing health quality assurance • Improving health care financing • Improving accessibility and quality of pharmaceuticals • E-health

  9. Strengthening Legal Framework-enhancing human rights in health and medicine- Umbrella laws: • Law on Health Care • Law on Protection of Patient Rights • Law on Mental Health • Law on Health Insurance

  10. Strengthening health system financing FACTS (main resources): • Contributions- 97,80% • Participation-services/drugs • Budget /Public Health Programs REFORMS (respond to the population needs): • Basic package of services • Upgrading financing of the public health/programs • Increasing of the HIF autonomy/management of HIF • HIF-strategic purchaser of services/contracting with the HC providers

  11. Introducing E-Health • Informatics system in the Health Insurance Fund • Implementation of the Hospital info systems in the chosen hospitals /possibility to broaden up on national level) • Development of the unique registers( unified code systems) • Implementation of the info systems by the chosen doctors in order to provide electronic information and exchange of information • Establishing of the E-health card • Diagnostic related group (DRG) as a standard system for medicinal and financial reporting • Electronic health dossier

  12. Investments in Health • National efforts: • Government has assigned 40 million euros for purchasing new medical equipment for the state owned health institutions • Investments in hospital infrastructure are decided upon /loan/ • Savings as investment (hospitals autonomy, hospital health care management improved, privatization in the primary level of health care) • Public-private partnerships encouraged • Foreign investments encouraged

  13. Patient centered health care-through acknowledging the value of providers (medical professionals) -socio-economic effects of transition on healthcare workforce at national level- • Working conditions, healthcare services - rapid changes • New technologies, high demands for realization • Loss of job, concurrence, restriction of funding, restructuring and privatization of the healthcare • Global health threats, migration

  14. Frequency of workplace stress factors in Examined and Control group of Healthcare workers ( N=250 subjects), Institute of OH, WHO CC, 2006

  15. THROUGHT EDUCATION – TO PATIENT SAFETY FOR ALL • Medical education development at all levels, in different profiles • Medical faculty, school of public health, faculty of dentistry, faculty of nursing … • 3 cycles education according to bologna declaration • Harmonisation of curricula • New programs, new teaching and learning methods • Mobility of students and teachers • Free movement of research and scientific ideas

  16. Thank you

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