My practice-Challenges in Romanian rural health care- meeting the needs of the community

1
My practice-Challenges in Romanian rural health
care- meeting the needs of the community
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The National context

• Approx. 11400 GPs working in mostly solo
  practices
• Nr. of patients/GP 1545,practice nurse/GP rate1.2
• GPs are the owners of the practice-their contract
  is renewed periodically
• Nr. of settlements without any health care
  provider 88, with a total of 153904 inhabitants
• Percentage of people without health insurance
  16.10
• Amongst EU states Romania has the most reduced
  percentage of GDP spent on health care- 5.5

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Facts

• contracted GP services
• feescapitation and service
• electronic prescriptions,implementation of
  electronic health records
• screening programmes-very limited

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What to improve?

• no existing clear national policies to address
  socio-economic determinants of health reduced
  access to health care, lack of local health
  services, poverty
• No feasible solutions are offered to bridge the
  gap between sporadic and continuous access to
  health care services
• The social care network is fragile, GP practices
  are the only one easily accessible health care
  providers in the rural communities
• Local primary care team can play a key role in
  offering tailored health services in the
  community,in building partnerships between
  different health service providers in the
  community

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Our intervention

• Our health centre is located in the north-western
  region of Romania
• We provide the community with the
  possibility of having ultrasound, ECG
  examinations, lab tests, physiotherapy, family
  planning services and access to prevention
  programs performed locally
• During the years we developed educational
  programs targeting different groups in the
  community, have done research activities to
  gather evidences in order to prove the importance
  of our activities
• The activities are ongoing and continuity helped
  developing partnership with the community

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Our intervention

• Integrated local health service delivery and
  multidisciplinary team work aimed to increase
  participation and meet the needs of the target
  population
• Pro-active approach exploring concerns and
  expectations
• With the primary care team as a core structure
  and coordinator, supported by local NGO and
  authorities basic health services, population
  screening and educational programs are accessible
  in the community
• Local and ongoing, reliable service delivery with
  no unexpected interruptions - necessity in
  building partnership and gaining credibility

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Our results

• Our approach of local service delivery in the
  community has helped to improve the relationship
  between our staff and the deserved population
  trust has lowered the threshold for contact
• The service must be ongoing and reliable to
  increase participation
• The model is sustainable as it uses local
  resources and is based on a partnership with the
  community
• The population must be a partner in reducing
  health inequalities