Management In Health, MIH (National School of Public Health, Management, Romania)
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Ethical Dilemmas of Intra-vitro Fertilization
No full textThe article reviews the issues of in vitro fertilization and the ethical dilemmas that rise from the impact of the medical, social, moral and legal framework of this method of assisted human reproduction, starting with the origin of gametes, the status of embryos and of biological or shedding parents, the maternal age, the sexual orientation of parents, the fate of embryos, the experimentation on embryo, taking into account the legislative framework, but also the moral and religious ones.The dilemmas are all under review, seeking to highlight the positive and negative aspects of the process, considering fairly the need of these techniques and the benefits of their use and the benefit they would bring to society. Key words: in vitro fertilization , ethics, embryo, medical legislation, genetic
Organization and Functioning of Medical-Social Services in the Swiss Health System
Get PDFArticolul consta in prezentarea sistemului sanitar elvetian, cu accent pe structura organizationala si pe managementul unor institutii de invatamant medical, spitale si asociatii non-profit care furnizeaza servicii de asistenta medicala si sociala in afara unei institutii spitalicesti, cele mai importante fiind unitatile de tip Spitex. Cuvinte cheie: organizarea sistemului de sanatate elvetian, servicii de asistenta medicala si sociala, unitate Spitex, spitale publice, spitale private, ingrijiri medicale la domiciliu.This article is to present the Swiss health system, focusing on organizational structure and management of medical educational institutions, hospitals and non-profit organizations, providing health care and social services outside of hospitals, the most important being Spitex domiciliary care units.Keywords: Swiss health system organization, health care and social services, Spitex domiciliary care units, public hospitals, private hospitals, home health care
De la performanta clinica la performanta programelor
No full textDiagnostic test results mark the beginning of a „production process of health”. Diagnostic procedures use health care resources, may have adverse effects, and can provide wrong results. Erroneous classifications may lead to unnecessary and possibly harmful treatment or even prevent or delay access to the right treatment. Therefore diagnostics are suitable subjects for economic evaluations. Various approaches for economic assessments with different levels of complexity have been presented in the past. High complexity and high level evaluations require comparatively considerable investments in time and budgets. Moreover, those complex approaches unfold their highest advantage in ex post evaluations, i.e. in summative product evaluations. Planning and budgeting a so called “production process of health” necessitates valid information on the performance of test and its likely intermediate outcomes in terms of correct classification of diseases and non-diseased population in specific situations. The clinical performance has to be adjusted by incorporating the peculiarities of an application, especially the influence of various prevalence rates at various locations of the disease under survey. This information has its highest value in the planning process, i.e. ex ante. This precondition of having valid information at hand at a very early point in time could be met by a less complex and less expensive approach that actually is based on five parameters, only.Rezultatele testelor pentru diagnosticare marcheaza inceputul unui „proces de productie de sanatate”. Procedurile diagnostic utilizeaza resurse ale ingrijirilor de sanatate, pot avea efecte secundare si pot furniza rezultate gresite. Clasificarile eronate pot conduce la tratamente inutile si posibil nocive sau pot chiar opri ori intarzia accesul la tratamentul corect. De aceea, diagnosticele constituie subiecte adecvate pentru evaluarile economice. In trecut au fost prezentate o serie de abordari pentru evaluarile economice cu diferite niveluri de complexitate. Evaluarile de complexitate ridicata si de nivel inalt necesita in timp investitii pe masura si bugete considerabile. Mai mult, aceste abordari complexe isi releva cel mai mare avantaj in evaluarile ex post, de exemplu in cadrul evaluarilor sumative de produs. Planificarea si bugetarea asa-numitului “proces de productie de sanatate” necesita informatii valide despre performanta testului si rezultatele lui intermediare in termeni de clasificare corecta a populatiei in bolnavi si non-bolnavi, in situatii specifice. Performanta clinica trebuie ajustata prin incorporarea particularitatilor unei aplicatii, in special influenta diferitelor rate de prevalenta a bolii in studiu de la diversele locatii. Aceste informatii sunt de cea mai mare valoare pentru procesul de planificare, respectiv ex ante. Aceasta conditie preliminara de a avea cat mai devreme la indemana informatii valide, ar putea fi indeplinita printr-o abordare mai putin complexa si mai ieftina, care se bazeaza numai pe cinci parametri
Contributie pentru a dezvolta noua sanatate publica in Europa de Sud Est, 2000-2010
No full textAim: To document the contribution of the Public Health Cooperation in South Eastern Europe (PH-SEE) Project during 2000-2010, to the development of the New Public Health in SEE. Methods: Critical analysis of the project activities and outcomes based on the relevant documents, Internet sources and published literature, as well as personal experience and observations of the authors as active contributors to the PH-SEE Network activities. Facts and findings: Within the last 10 years South Eastern Europe (SEE) countries have been experiencing a kind of renaissance or revolution of public health in their region. There has been undergoing profound changes with raising awareness, capacity building in public health and health management, and preparing target-oriented public health practitioners, researchers, health policy analysts and managers for health care institutions. A strong network for long-term cooperation was established among public health institutions and professionals in the SEE region. Advancements in the teaching and research in public health and analysis/formulation of national health policies were followed by curriculum development for Master in Public Health and establishment of Public Health postgraduate education programmes/centres/schools of public health in almost each country in the SEE region. Among the most tangible outcomes of the Project were the handbooks for teachers, researchers and public health professionals. Six volumes were published so far, and the seventh one will be published next year, 2011. Conclusion: The PH-SEE project has been a real success, not only in terms of achieving its goals related to public health development in the region by raising training and research capacity, but also in terms of inter-country cooperation, getting in the line with the Stability Pact for South Eastern Europe main goal of strengthening the efforts of the countries of the region in fostering peace, democracy, respect for human rights and economic prosperity.Scop: Documentarea contributiei aduse de Proiectul de Cooperare in Domeniul Sanatatii Publice in Europa de Sud Est (PH-SEE) intre 2000-2010 pentru a dezvolta Noua Sanatate Publica in Europa de Sud Est. Metoda: Analiza critica a activitatilor si rezultatelor proiectului in baza documentelor relevante, a surselor existente pe internet si a literaturii publicate, precum si a experientei si observatiilor personale ale autorilor care au contribuit efectiv la activitati in cadrul retelei PH-SEE. Date si aspecte relevante: In ultimii 10 ani tarile din Sud Estul Europei au experimentat o renastere sau, altfel spus, o revolutie a sanatatii publice in regiune. Astfel, au avut loc schimbari profunde inregistrandu-se o crestere a gradului de recunoastere a acestui domeniu, dezvoltarea capacitatii in sanatate publica si management sanitar, precum si pregatirea specifica in acest domeniu a numerosi medici, cercetatori, analisti ai politicilor de sanatate si manageri ai institutiilor medicale. O puternica retea de cooperare pe termen lung a fost stabilita intre institutii si profesionisti din tari ale Europei de Sud Est. Progresele in privinta invatamantului si cercetarii in sanatatea publica si analiza/formularea politicilor nationale de sanatate publica au fost urmate de dezvoltarea curriculei de pregatire pentru cursul de Master in Sanatate Publica si stabilirea de programe de formare postuniversitara/centre/scoli de sanatate publica in aproape toate tarile din regiune. Printre cele mai tangibile rezultate ale Proiectului s-au numarat manualele destinate formatorilor, cercetatorilor si specialistilor de sanatate publica. Sase volume au fost deja publicate, al saptelea urmand sa fie publicat in 2011. Concluzii: Proiectul PH-SEE a inregistrat un real succes, nu doar in privinta atingerii obiectivelor sale legate de dezvoltarea sanatatii publice in regiune prin cresterea capacitatii de formare si cercetare, dar si in privinta cooperarii intre tarile din regiune, aliniindu-se astfel principalului obiectiv al Pactului de Stabilitate pentru Europa de Sud Est, si anume intensificarea eforturilor tarilor din regiune pentru asigurarea pacii, democratiei, respectarii drepturilor omului si prosperitatii economice
Criterii de analiza ale unui contract de asigurare de viata
No full textBesides the established functions of the insurance, those regarding the prevention and the compensation of the damages and the payment of the insured sums, in the last decades the financial side of insurances has got a big importance. On one side the specialized companies are more and more involved in the financial market, looking the best investments; on the other side, they offer the clients a very wide range of life insurances with capitalized component.In this material there are described the main products of this type and there are presented some criteria of analysis and selection of contracts depending on their adaptation to the needs and the personal situation of each insured.Keywords: life insurance, criteria of analysisIn afara functiilor consacrate ale asigurarii, cele privind prevenirea si compensarea daunelor si de plata a sumelor asigurate, in ultimele decenii a capatat o tot mai mare importanta latura financiara a asigurarilor. Pe de o parte societatile specializate se implica tot mai mult pe piata financiara, cautand cele mai bune plasamente, pe de alta parte ele ofera clientilor o gama foarte diversificata de asigurari de viata, cu componenta de capitalizare. In prezentul material sunt descrise principalele produse de acest tip si sunt enuntate cateva criterii de analiza si selectie a contractelor, in functie de adaptarea lor la nevoile si situatia personala a fiecarui asigurat.Cuvinte cheie: asigurare de viata, criterii de analiz
Evenimentele adverse sunt periculoase dar pot fi prevenite
No full textIn the last decades the progress of scientific knowledge and technologies created very complex healthcare systems, which can deliver diagnostic and treatment services at high standards for millions of people. Unfortunately, together with the positive effects, the high complexity of the organization and functioning of healthcare organizations brings also high risks for patient safety, due to the occurrence of adverse events. These events can physically and psychologically harm or even kill the patient. It is considered that one of 10 patients is harmed by such an event during the medical care. The medical staff is also affected by the moral, administrative and judicial consequences. Therefore, all the countries are making efforts to improve patient safety. The studies have shown that the majority of adverse events are preventable, so that there is a need to develop and apply specific instruments for error prevention and harm reduction. Patient safety becomes a discipline with a specific body of knowledge and expertise. This article presents some of the main concepts and best practice models in patient safety, in order to improve the awareness of the decision makers and health professionals for patient safety in Romania.In ultimile decade, avansul cunostintelor stiintifice si al tehnologiei au dus la dezvoltarea unor sisteme de sanatate complexe, ce au permis depistarea si tratarea cu succes a afectiunilor a milioane de persoane. Din pacate, odata cu efectele pozitive, complexitatea organizarii si functionarii sistemelor de sanatate, aduce si riscuri crescute pentru siguranta pacientilor, prin aparitia evenimentelor adverse. Acestea pot produce vatamarea fizica si psihica sau chiar moartea pacientilor. Se considera ca aproximativ unul din 10 pacienti sufera un asemenea accident in cursul ingrijirilor. Personalul medical implicat este de asemenea afectat, suferind consecinte morale, administrative si juridice. De aceea, toate tarile fac eforturi majore pentru siguranta pacientilor. Studiile au aratat ca majoritatea evenimentelor adverse sunt evitabile si pentru aceasta este necesara dezvoltarea si aplicarea unor instrumente specifice de prevenire a erorilor si reducere a afectarii pacientilor. Siguranta pacientului s-a dezvoltat astfel ca o disciplina, bazata pe cunostinte si expertiza specifica. Articolul prezinta cateva dintre principalele concepte si modele de buna practica, in scopul sensibilizarii decidentior si profesionistilor din sanatate, cresterea sigurantei pacientilor in Romania
Managementul bolilor cardivasculare
No full textInterview with Prof. Radu Deac, MDInterviu cu Prof. Univ. Dr. Radu Dea
Strategia Ministerului Sanatatii pe termen scurt si mediu
No full textInterview with the Health Minister CSEKE ATTILAInterviu cu Ministrul Sanatatii Cseke Attil
Medicina de dezastru sau Managementul medical al dezastrului, o noua specialitate medicala
No full textDuring the past decades, it was developed a new subject of study which deals with the isssues of medical management of crisis situations – the new concept is the DISASTER MEDICINE. The fact that war is the ultimate disaster explains why military medicine has played an important role in the development of Disaster Medicine. On the other hand, correct solving daily emergencies can be seen as a form for medical staff training for intervention in special circumstances, from the collective accidents up to major disasters.In conclusion, it can be said that disaster medicine has its own identity, even if it draws on the attitudes and methods of emergency medicine and the military medicine.Keywords: Disaster Medicine, Military Medicine, Emergencies, Medical Emergencies, Hygiene and Public Health, Medical Management of DisastersIn ultimele decade a aparut o noua materie de studiu si anume medicina de dezastru, care abordeaza probleme de management medical al situatiilor de criza, capatand contur sub conceptul – MEDICINA DE DEZASTRU. Avand in vedere ca razboiul este dezastrul de cea mai mare amploare, asa se explica si de ce medicina militara are un important rol in dezvoltarea Medicinii de Dezastru. Pe de alta parte, rezolvarea corecta a urgentelor zilnice poate fi interpretata ca o forma de antrenament pentru pregatirea personalului medical in interventia in situatii speciale, de la accidente colective pana la dezastrele de mare amploare. In concluzie, se poate afirma ca medicina de dezastru poseda o identitate proprie, chiar daca se inspira din atitudinile si metodele medicinii de urgenta si a celei militare.Cuvinte cheie: Medicina de Dezastru, Medicina Militara, Situatii de Urgenta, Urgente medicale, Igiena si Sanatatea Publica, Managementul Medical al Dezastrelo