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  1. 1. Ministry of Health, Labour and Social welfare Montenegro HEALTH SYSTEM MONTENEGRO
  2. 2. <ul><li>Strategy defines the elements of planning activities, </li></ul><ul><li>which shall be carried out in the health system, with the </li></ul><ul><li>aim to undertake political, economic, social, scientific, </li></ul><ul><li>expert, management, and legislative measures to reform </li></ul><ul><li>the health system. </li></ul><ul><li>The strategy for health reform opens up the process of </li></ul><ul><li>necessary reform to the health system in Montenegro, </li></ul><ul><li>which shall provide better quality health care, improve </li></ul><ul><li>health and improve the state of health of the population. </li></ul>THE MINISTRY OF HEALTH FOR THE OF MONTENEGRO HAVE PASSED ON THE HEALTH DEVELOPMENT STRATEGY ON SEPTEMBER OF 2003
  3. 3. 4 KEY PRINCIPLES OF REFORM <ul><li>UNIVERSALITY </li></ul><ul><li>EQUALITY </li></ul><ul><li>ACCESSIBILITY </li></ul><ul><li>QUALITY AND EFFICIENCY </li></ul>Health policy, which has the aim to carry out health system reform, shall proceed from the following general principles:
  4. 4. THE HEALTH DEVELOPMENT PROJECT (2004-2008) <ul><li>Health care Law </li></ul><ul><li>Health care insurance Law </li></ul><ul><li>Compulsory records in the field of health care </li></ul><ul><li>Law on Medicines and </li></ul><ul><li>Law on medicinal products </li></ul><ul><ul><li>Health development P roject is a base of Primary Health care reform (financed by World bank and CIDA) </li></ul></ul><ul><ul><li>First step - Establishing of legal frame for carr y ing out Primary Health care reform </li></ul></ul>PASSED SO FAR TO BE PASSED <ul><li>The Law on patient rights </li></ul><ul><li>The law on health care </li></ul><ul><li>The law on transplantation </li></ul><ul><li>The law on assistant reproductive tehnologies </li></ul><ul><li>The law on genetic privacy </li></ul><ul><li>The law on taking of biological samples </li></ul>
  5. 5. BASIC CONCEPT OF PRIMARY HEALTH CARE REFORM <ul><li>The chosen doctor project is already tested in Primary Health care Center Podgorica, and it is already implemented into others parts of our state. </li></ul><ul><li>c hosen doctor for adults </li></ul><ul><li>chosen doctor for children </li></ul><ul><li>chosen doctor for women </li></ul><ul><li>It is espected that chosen doctor activities should tak e health care of 80% of diseases </li></ul><ul><li>Primary Health care Center is becoming the center of support for the chosen docto r activities </li></ul><ul><li>Standards and regulations regarding to work of chosen doctor </li></ul><ul><li>Primary Health care Centers are supplied by equpment according to needs of the reform; </li></ul><ul><li>Reconstruction and adaptation of Primary Health care Centers </li></ul><ul><li>Education of medical staff is organised trough three levels of education: </li></ul><ul><ul><li>continuing education of medical staff on primary health level </li></ul></ul><ul><ul><li>continuing education of specialists </li></ul></ul><ul><ul><li>establishing of cathedre for family medicine </li></ul></ul>
  6. 6. NEW MODEL OF GOVERNANCE AND FINANCING ON PRIMARY LEVEL OF HEALTH CARE <ul><li>New role of m a naging health care institution on primary level (streng h tening of administrative capaticies trough advanced level of education - CIDA Project) </li></ul><ul><li>The new method for payment of primary health care is established - combination per capita payment and payment for services provided by chosen doctor . </li></ul><ul><li>This kind of payment will start from January 2009. </li></ul>
  7. 7. DENTISTRY REFORM <ul><li>Privatization of dentistry service </li></ul><ul><li>Chosen dentist, privatiser provides services included in general pocket of services (children up to 18 years old, pregn a nt women;emergency cases and persons over 65 years old ) </li></ul><ul><li>Services are prov i d e d on contract basis (between Health Insurance Found and chosen dentist) </li></ul>
  8. 8. <ul><li>A n electronic citizen’s health card is established as a central element for medical documentation </li></ul><ul><li>Integrated Health information system is established in order to support Primary Health Care reform </li></ul><ul><li>Each citizen will have his own electronic card which will keep certain data about each user, thus contributing the improvement of health services quality </li></ul><ul><li>Enable access to data by different participants in the health system according to the defined levels of access. </li></ul><ul><li>Including of electronic invoice which will be sent to Public Health Institute and Ministry of Health, Labour and Social Welfare </li></ul>HEALTH CARE INFORMATION SYSTEM New health care information system is implemented in order to carry out PHCR
  9. 9. FURTHER STEPS OF HEALTH CARE REFORM <ul><li>All activities regarding primary health care reform are going to be finished b y the end of 2008 . </li></ul><ul><li>present problems on secondary and tertiary health care level: </li></ul><ul><li>L ack of separation between secondary and tertiary health care </li></ul><ul><li>L ack of efficiency </li></ul><ul><li>Irracional and uncontrolled drug consumption and l ack of system control </li></ul><ul><li>Unefficient health care institution m a naging </li></ul><ul><li>I nadequate me c hani s m of prov i ding health care services </li></ul>
  10. 10. FURTHER STEPS OF HEALTH CARE REFORM <ul><ul><li>TASKS: </li></ul></ul><ul><ul><li>Establishing of standards and regulations regarding prov i ding of health services </li></ul></ul><ul><ul><li>Establishing General Pocket of services, </li></ul></ul><ul><ul><li>creating of clinical protocols and guidelines </li></ul></ul><ul><ul><li>Implementation of new payment method </li></ul></ul><ul><ul><li>Establishing of Health institution network </li></ul></ul><ul><ul><li>WE ARE AW A RE THAT: </li></ul></ul><ul><ul><li>This is very complex and long term process which depends on social and economic development, </li></ul></ul><ul><ul><li>Expiriences of other countries are a very pre s cious help for us, but nevertheless every country is sup p ose d to chose an adequate model of reform </li></ul></ul><ul><ul><li>T he 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 </li></ul></ul>