Suchergebnisse

Recent international research indicates that health care systems with stronger focus on primary care have better outcomes for less money than those with a strong focus on hospital care (Macinko, 2003; Starfield, 1998; 2005). This means that strong primary care increases sustainability of all health care systems. Nevertheless, when comparing different countries, the term primary care has different meanings and there are various forms of primary health care systems and providers. New challenges are ageing population, burden of chronically ill patients, new expensive technologies and increased overall costs of health care. Politicians and payers now more than ever are interested in efficiency and sustainability of health care systems in order to give best value for money. The objective of the article is to summarize the existing primary health care performance indicators and list potential PHC quality indicators that would support a more sustainable health care system in Lithuania. This article is based on the "Improvement of public health by promoting equitably distributed, high quality primary health care systems" (ImPrim) project and the activities related to elaboration of an operational evidence system based and widely recognised as quality indicators for PHC performance. This study was prepared using relevant literature, websites, but also several e-mail contacts, phone calls, workshops, seminars and practices. In summary, Lithuania health care quality needs to be assessed from the point of view of structure, process and outcomes. Such the stakeholders as patients, health care providers, professionals, financiers and also decision-makers (politicians) should be involved in the development and the selection of quality indicators. [.]

Recent international research indicates that health care systems with stronger focus on primary care have better outcomes for less money than those with a strong focus on hospital care (Macinko, 2003; Starfield, 1998; 2005). This means that strong primary care increases sustainability of all health care systems. Nevertheless, when comparing different countries, the term primary care has different meanings and there are various forms of primary health care systems and providers. New challenges are ageing population, burden of chronically ill patients, new expensive technologies and increased overall costs of health care. Politicians and payers now more than ever are interested in efficiency and sustainability of health care systems in order to give best value for money. The objective of the article is to summarize the existing primary health care performance indicators and list potential PHC quality indicators that would support a more sustainable health care system in Lithuania. This article is based on the "Improvement of public health by promoting equitably distributed, high quality primary health care systems" (ImPrim) project and the activities related to elaboration of an operational evidence system based and widely recognised as quality indicators for PHC performance. This study was prepared using relevant literature, websites, but also several e-mail contacts, phone calls, workshops, seminars and practices. In summary, Lithuania health care quality needs to be assessed from the point of view of structure, process and outcomes. Such the stakeholders as patients, health care providers, professionals, financiers and also decision-makers (politicians) should be involved in the development and the selection of quality indicators. [.]

Healthcare governance has introduced new organizational requirements for social responsibility, not only for the quality and efficiency of the institutions but also for the organization's behavior and employee's thinking, their motivations and expectations, shaping new values and beliefs, understanding organizational culture as a whole traditions, cultural self-awareness, organization and employee aspirations over the last five years. It requires the development of a multidimensional organization development direction, an organization's strategic approach to the formation of its culture and its interaction with an outside institutional environment. Heads of health care institutions and top managers need to develop and develop their organizational skills, improve their administrative practices, and systematically analyze their needs. Lithuania's integration into the European Economic Area determines both the development of new technologies, higher quality standards for health services and the need for medical professionals to compete with Western European service providers. It is a multidisciplinary process that creates new challenges for the country.

Healthcare governance has introduced new organizational requirements for social responsibility, not only for the quality and efficiency of the institutions but also for the organization's behavior and employee's thinking, their motivations and expectations, shaping new values and beliefs, understanding organizational culture as a whole traditions, cultural self-awareness, organization and employee aspirations over the last five years. It requires the development of a multidimensional organization development direction, an organization's strategic approach to the formation of its culture and its interaction with an outside institutional environment. Heads of health care institutions and top managers need to develop and develop their organizational skills, improve their administrative practices, and systematically analyze their needs. Lithuania's integration into the European Economic Area determines both the development of new technologies, higher quality standards for health services and the need for medical professionals to compete with Western European service providers. It is a multidisciplinary process that creates new challenges for the country. ; Per paskutinius penkerius metus sveikatos priežiūros valdymas iškėlė naujus organizacijų socialinės atsakomybės reikalavimus siekiant ne tik institucijų veiklos kokybės ir efektyvumo, bet ir organizacijų elgsenos bei darbuotojų mąstymo, jų motyvacijų ir lūkesčių pokyčių, formuojant naujas vertybes ir įsitikinimus, suprantant organizacijos kultūrą kaip visumą pažiūrų, tradicijų, kultūrinės savimonės, organizacijos ir darbuotojų tapatybės siekių. Tai reikalauja daugiadimensiško organizacijos vystymosi krypčių nustatymo, organizacijos strateginio požiūrio į jos kultūros formavimo ir sąveikos su išore institucine aplinka. Sveikatos priežiūros įstaigų vadovai ir aukščiausio rango vadybininkai turi vystyti ir plėtoti organizacinius gebėjimus, tobulinti administravimo praktiką, sistemingai analizuoti žmogiškųjų išteklių poreikį. Lietuvos integracija į Europos ekonominę erdvę lemia tiek naujų technologijų plėtrą, aukštesnius kokybinius sveikatos paslaugų standartus, tiek būtinybę dėl medicinos specialistų konkuruoti su Vakarų Europos valstybių paslaugų teikėjais. Tai daugiadisciplininis procesas, keliantis šaliai naujus iššūkius.

Recently, the sphere of mental health is under consideration, the decisions involve organizations into the process of turnover. This process results the need of project management. The aim of this work is to perform a theoretical analysis of the situation in mental health care and social care institutions, to analyze the policy of government in solving problems of these institutions and empirically investigate the motivation and possibilities to change during the process of project management. These institutions were selected consider the fact that, that institutional services, provided to mentally disabled persons, need essential changes because of high costs and lack of quality. In Lithuania the process of modernization is directed to establishment of community services network and optimization of existing institutional services. The part of European Union funds will be provided to implement these goals. To sum up, it is important participation of every institution in developing and implementing projects. The main tasks of empirical part are: 1) to research a motivation of institutions to implement projects; 2) to explore possibilities of institutions to implement projects; 3) to find out an attitude to project management; 4) to identify which factors by the respondent's opinion make the biggest influence on changes in mental health care and social care fields; 5) to compare the answers of mental health care and social care workers. The research was obtained by using questionnaire. 68 persons, working with mental disability patients, participated in the research. Social workers presented 75 percent of total respondents. The research results disclosed that institutions, which had experience in project implementation, would continue this activity. The workers, who have been involved in development of projects, were more motivated to develop and implement the projects also more satisfied with present job than those, who haven't been involved in development of projects. The research disclosed that psychiatric hospitals have better human and financial recourses for development and implementation of projects, but social care institutions these resources defined as low or very low. In opinion of respondents, the project management provides a possibility to change; despite this in a part it means an additional level of bureaucracy in delivery of services. On the other hand, a positive evaluation of competition and opinion that social institutions should demonstrate that they are providing effective services make a favorable condition to implement changes.

Recently, the sphere of mental health is under consideration, the decisions involve organizations into the process of turnover. This process results the need of project management. The aim of this work is to perform a theoretical analysis of the situation in mental health care and social care institutions, to analyze the policy of government in solving problems of these institutions and empirically investigate the motivation and possibilities to change during the process of project management. These institutions were selected consider the fact that, that institutional services, provided to mentally disabled persons, need essential changes because of high costs and lack of quality. In Lithuania the process of modernization is directed to establishment of community services network and optimization of existing institutional services. The part of European Union funds will be provided to implement these goals. To sum up, it is important participation of every institution in developing and implementing projects. The main tasks of empirical part are: 1) to research a motivation of institutions to implement projects; 2) to explore possibilities of institutions to implement projects; 3) to find out an attitude to project management; 4) to identify which factors by the respondent's opinion make the biggest influence on changes in mental health care and social care fields; 5) to compare the answers of mental health care and social care workers. The research was obtained by using questionnaire. 68 persons, working with mental disability patients, participated in the research. Social workers presented 75 percent of total respondents. The research results disclosed that institutions, which had experience in project implementation, would continue this activity. The workers, who have been involved in development of projects, were more motivated to develop and implement the projects also more satisfied with present job than those, who haven't been involved in development of projects. The research disclosed that psychiatric hospitals have better human and financial recourses for development and implementation of projects, but social care institutions these resources defined as low or very low. In opinion of respondents, the project management provides a possibility to change; despite this in a part it means an additional level of bureaucracy in delivery of services. On the other hand, a positive evaluation of competition and opinion that social institutions should demonstrate that they are providing effective services make a favorable condition to implement changes.

The Constitution of the World Health Organization (WHO) states that one of the most important rights of every human is to stay healthy; therefore, national politicians must constantly search for new and effective ways to achieve this. In a fastpaced world, with ageing population and health care institutions faced with huge costs, as health care struggles to change to meet these demands, medical self-diagnosis (the process of diagnosing, or identifying, medical conditions in oneself, with the use of computer technology) has recently become increasingly popular in the world. The aim of this article is to review international practice in the field of medical self-diagnosis and investigate society's attitude towards medical self-diagnosis in Lithuania. Starting about in the 1980s, first medical self-diagnosis programs were developed worldwide; however, the term "medical self-diagnosis" is not yet widely known in Lithuania, and the opportunities of medical self-diagnosis have not yet been defined in the legislation of the country. According to study results, the attitude of Lithuanian people to medical self-diagnosis is favourable as self-diagnosis is acceptable to 68.2 percent of respondents. In order for medical self-diagnosis software to be popular among residents of Lithuania, developers must ensure that it is easy to use and comes from a trustworthy service provider.

The Constitution of the World Health Organization (WHO) states that one of the most important rights of every human is to stay healthy; therefore, national politicians must constantly search for new and effective ways to achieve this. In a fastpaced world, with ageing population and health care institutions faced with huge costs, as health care struggles to change to meet these demands, medical self-diagnosis (the process of diagnosing, or identifying, medical conditions in oneself, with the use of computer technology) has recently become increasingly popular in the world. The aim of this article is to review international practice in the field of medical self-diagnosis and investigate society's attitude towards medical self-diagnosis in Lithuania. Starting about in the 1980s, first medical self-diagnosis programs were developed worldwide; however, the term "medical self-diagnosis" is not yet widely known in Lithuania, and the opportunities of medical self-diagnosis have not yet been defined in the legislation of the country. According to study results, the attitude of Lithuanian people to medical self-diagnosis is favourable as self-diagnosis is acceptable to 68.2 percent of respondents. In order for medical self-diagnosis software to be popular among residents of Lithuania, developers must ensure that it is easy to use and comes from a trustworthy service provider.

Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients' rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute's questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages.

Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients' rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute's questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages.

Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients' rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute's questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages.

Objects of dissertation: the quality in health care inpatient institutions and health damage compensation in medical malpractice litigation cases. This work is a scientific assessment of the implementation of the patients' rights to quality in health care and health damage compensation in Lithuania, where the functioning of two patients' rights is assessed in a systematic and integrated manner, both in the medical and the legal aspect. Research: the modified Picker Institute's questionnaire was used for the scientific research of 1917 patients treated in hospitals in order to examine and assess their opinions on the quality of health care provided to them and evaluate the opportunities to realize their right to health care of good quality. The study analyzed 32 medical malpractice lawsuit cases of general jurisdiction courts in terms of the principles of health damage compensation, procedural characteristics and efficiency. Conclusions: statutory regulation of patients 'rights to quality in health care services and health damage compensation in Lithuania meets international and European patients' rights protection principles. The research showed that the vast majority of surveyed patients (nine out of ten) realized their right to quality in health care service in the hospital. However, six out of ten plaintiffs received the health damage compensation, plaintiffs were awarded only nearly a fifth of the requested overall pecuniary and non-pecuniary damages.

Therefore, the content analyses of these concepts are to intend and to disclose the usage of health care terminologies some problematic aspects. The research is relevant and at the theoretical level. For the first time in the Health law doctrine of Lithuania is systematically analyzing the questions of mental health terminology legislation.

Therefore, the content analyses of these concepts are to intend and to disclose the usage of health care terminologies some problematic aspects. The research is relevant and at the theoretical level. For the first time in the Health law doctrine of Lithuania is systematically analyzing the questions of mental health terminology legislation.

Public health is as important as the persons, but funding still remains a problem. Therefore, the study of the financing aspects of the programs, can be identified the main administrative and management problems for the future to ensure the most efficient administration of the programs. The aim of this work is to establish the EU and Lithuanian program funding aspects and to identify related key issues. In this study will be analyzed the programs in a number of priority areas of EU public health strategy - it is alcohol, tobacco, women's health, drugs and HIV / AIDS and mental health. Work consists of 3 large parts. The first part presents the survey methodology. Described the positive and negative aspects of decentralization theory. It also presents the theoretical models of health care financing, which funded public health programs. The second part presents the EU Public Health Strategy 2008 - 2013, the public health system of Lithuania adequacy with EU priorities, discussed financing of a programs and a wide range of programs development and financing problems. In the third part, invoke in a qualitative semi-structured interview method, investigation of the focus group is presented. Defined the implementation of public health, the EU funds, the major public health programs and funding assessment of the experts prospect. During the analysis of EU and Lithuanian public health programs financing and the investigation, identified a mixed funding model in the public health programs field, analyzed the main drawbacks of decentralization, noted that some of the Lithuanian public health strategy goals are under-performed. Identified the following main problems of financing: a small financial interest, not enough consolidated public health importance, negative aspects if co-funding principle, the lack of intersectoral cooperation, lack of functions implementation, supervision and financing, lack of systemic approach, the lack of continuity, doubled functions, business priority, the breakdown strength, weak cooperation between the representatives in the European Union and the national authorities, the complex bureaucratic mechanism, the possible personal interests, financial and strength concentration of certain institutions.