Health quality issues are embedded in our vision for future health. Quality is one of the main priorities for the patient to choose one or the other service. Therefore, it is very important to evaluate the quality of services provided, to understand how health care quality policy is formulated, implemented and evaluated in Lithuania. Research object – quality policy analysis in the healthcare system. Research problem – how is health care quality policy formulated, implemented and evaluated in Lithuania? Research aim – analyze the appropriateness of quality policies in the healthcare system.
Health quality issues are embedded in our vision for future health. Quality is one of the main priorities for the patient to choose one or the other service. Therefore, it is very important to evaluate the quality of services provided, to understand how health care quality policy is formulated, implemented and evaluated in Lithuania. Research object – quality policy analysis in the healthcare system. Research problem – how is health care quality policy formulated, implemented and evaluated in Lithuania? Research aim – analyze the appropriateness of quality policies in the healthcare system.
The Master's thesis covers the analysis of the health care sector financing models and the measures used to describe the effectiveness of the health care sector were presented. An analysis of health care sector infrastructure and financing has been conducted. The work is divided into three main parts: The first part examines the historical health insurance models and compares them with the systems currently in place across various countries. After analyzing the scientific literature, the most frequently used measures used by scientists to assess and evaluate the effectiveness of the health care sector were identified and classified. The second part of the thesis presents the methodology of the health care sector research: a health care sector assessment model is designed, analysis of the Pabon Lasso model is performed and the budget research methodologies of the Compulsory Health Insurance Fund are also presented. In the third section, based on the current legal acts and the data provided by the institutions involved, the Lithuanian health care system is analyzed: its structural units and processes are identified along with financing schemes. An analysis of the use of active treatment beds in Lithuanian hospitals was carried out using the Pabon Lasso model, calculating the turnover of beds operating in hospitals and the rate of occupancy. An analysis of the dynamics and structure of the budget of the Compulsory Health Insurance Fund for 20102018 has been competed, and the implementation of the plan has been assessed. The statistical data of Lithuania and the European Union countries were also analyzed: the number of beds, doctors and health expenses from GDP.
The Master's thesis covers the analysis of the health care sector financing models and the measures used to describe the effectiveness of the health care sector were presented. An analysis of health care sector infrastructure and financing has been conducted. The work is divided into three main parts: The first part examines the historical health insurance models and compares them with the systems currently in place across various countries. After analyzing the scientific literature, the most frequently used measures used by scientists to assess and evaluate the effectiveness of the health care sector were identified and classified. The second part of the thesis presents the methodology of the health care sector research: a health care sector assessment model is designed, analysis of the Pabon Lasso model is performed and the budget research methodologies of the Compulsory Health Insurance Fund are also presented. In the third section, based on the current legal acts and the data provided by the institutions involved, the Lithuanian health care system is analyzed: its structural units and processes are identified along with financing schemes. An analysis of the use of active treatment beds in Lithuanian hospitals was carried out using the Pabon Lasso model, calculating the turnover of beds operating in hospitals and the rate of occupancy. An analysis of the dynamics and structure of the budget of the Compulsory Health Insurance Fund for 20102018 has been competed, and the implementation of the plan has been assessed. The statistical data of Lithuania and the European Union countries were also analyzed: the number of beds, doctors and health expenses from GDP.
Public healthcare institutions face a variety of tasks to provide the public with high quality services. Those serving a prison sentence are not an exception. These individuals are a part of our society; they are only temporarily isolated, but eventually return to it. Imprisoned, they carry the same health problems that exist outside. Incarcerated individuals tend to show standards of behavior that had already formed before prison and which can predispose the fast spread of infection in a closed group. The health care questions of these individuals are a component of public healthcare and it is integral to ensure that healthcare is as available to the public as possible. The provision of public services has a deep tradition: general consensus is that, due to differences in public administration, forming equal for every country, unchangeable mechanisms of providing healthcare services is impossible. Therefore, having evaluated the quality of healthcare services of the Lithuanian Healthcare System and the Central Prison Hospital, it is appropriate to search for innovative solutions that are based not only on the experience of advanced foreign countries, but on the economy, the socio-cultural environment and politics of our country.
Public healthcare institutions face a variety of tasks to provide the public with high quality services. Those serving a prison sentence are not an exception. These individuals are a part of our society; they are only temporarily isolated, but eventually return to it. Imprisoned, they carry the same health problems that exist outside. Incarcerated individuals tend to show standards of behavior that had already formed before prison and which can predispose the fast spread of infection in a closed group. The health care questions of these individuals are a component of public healthcare and it is integral to ensure that healthcare is as available to the public as possible. The provision of public services has a deep tradition: general consensus is that, due to differences in public administration, forming equal for every country, unchangeable mechanisms of providing healthcare services is impossible. Therefore, having evaluated the quality of healthcare services of the Lithuanian Healthcare System and the Central Prison Hospital, it is appropriate to search for innovative solutions that are based not only on the experience of advanced foreign countries, but on the economy, the socio-cultural environment and politics of our country.
The article examines the extent to which European Union competition law is applicable to public healthcare services. For this purpose, the article analyses the notion of company within the meaning of competition law and aims to establish how this notion could be applied to public healthcare services. It furthermore considers the application to public healthcare of Articles 106 and 107-109 of the Treaty on the Functioning of the European Union (TFEU) establishing derogations from EU competition rules. The article compares the extent of the application of the competition law to public healthcare with that one of the internal market freedoms. The analysis and the conclusions in the article are based on the EU legal acts, documents of the European Commission and cases in the area of public services and competition law decided by the Court of Justice of the EU and the General Court.
The article examines the extent to which European Union competition law is applicable to public healthcare services. For this purpose, the article analyses the notion of company within the meaning of competition law and aims to establish how this notion could be applied to public healthcare services. It furthermore considers the application to public healthcare of Articles 106 and 107-109 of the Treaty on the Functioning of the European Union (TFEU) establishing derogations from EU competition rules. The article compares the extent of the application of the competition law to public healthcare with that one of the internal market freedoms. The analysis and the conclusions in the article are based on the EU legal acts, documents of the European Commission and cases in the area of public services and competition law decided by the Court of Justice of the EU and the General Court.
SUMMARY THE PROBLEMS OF IMPLEMENTATION OF PATIENTS' RIGHTS IN HEALTHCARE INSTITUCIONS IN THE EUROPEAN UNION AND NATIONAL LAW Patients' rights and ensuring their protection is a problem of international level, therefore when implementing these rights in the legislation of the Republic of Lithuania has to be oriented towards principles acknowledged on international level. The purpose of this work is to analyse patients' rights defined by the acts of the European Union and international law and transferrance of the principles of these law acts into national law and implementation of those rights in healthcare institutions. The work has conducted analysis of the major documents of the European Union on ensuring patients' rights. The standart foundation of the European Union's human rights protection are the following sources: The Convention for the Protection of Human Rights and Fundamental Freedoms, the constitutions of the countries comprising the European Union and general principles in the area of the protection of human rights. Therefore the constitutions of European countries, the Convention for the Protection of Human Rights and other acts of the European Union and international law and the practice of the European Court of Human Rights and the European Court of Justice examining cases on defending patients' rights as well have been analysed. The work reveals peculiarities of patients' rights regulations in the acquis communautaire of the European Union. It could be stated that these acts of law do not directly specify patients' rights as separate personal rights. The following patients' rights could generaly be emphasized: right to get service with appropriate level of carefulness, right to safe healthcare, right to access to information and that information will not be disclosed, right to get personal treatment method and other rights. The regulation of all these rights in international law has to be transferred to national law. The most important acts of the Republic of Lithuania (RL), firstly the Constitution of RL, the Civil Code of RL, Patients' Rights and the law of the remuneration of health harm of RL have been analysed in this aspect in this work. The problems of implementing patients' rights in Lithuania have also been revealed in this work. It shows that patients are displeased with lack of doctors' attention, do not trust a doctor treating them, get little information about the development of an illness, their time is not respected and their right to choose a doctor although stated in the law is not implemented in practice. Right to confidentiality is regulated according to the Civil Code of RL, but patients think that in practice confidential information is not secured enough. Having analysed acts of law of RL and practice of the courts of RL it has been established that for example, right to appeal is implemented only partly, because almost half patients do not know where to appeal when they are not satisfied with service. Implemetation of right to compensation (remuneration of harm) is especially relevant, so this problem has been treated quite in detail. The work has analysed effectiveness of how patiens unite into public organisations and the most important aspects of this process have been emphasized. General conclusions have been formulated drawing on the done analysis and suggestion offerred about regulation of patients' rights and perfection of its implementation in Lithuania. Keywords: patient, healthcare institution, patients' rights, law acts, civil responsibility.
SUMMARY THE PROBLEMS OF IMPLEMENTATION OF PATIENTS' RIGHTS IN HEALTHCARE INSTITUCIONS IN THE EUROPEAN UNION AND NATIONAL LAW Patients' rights and ensuring their protection is a problem of international level, therefore when implementing these rights in the legislation of the Republic of Lithuania has to be oriented towards principles acknowledged on international level. The purpose of this work is to analyse patients' rights defined by the acts of the European Union and international law and transferrance of the principles of these law acts into national law and implementation of those rights in healthcare institutions. The work has conducted analysis of the major documents of the European Union on ensuring patients' rights. The standart foundation of the European Union's human rights protection are the following sources: The Convention for the Protection of Human Rights and Fundamental Freedoms, the constitutions of the countries comprising the European Union and general principles in the area of the protection of human rights. Therefore the constitutions of European countries, the Convention for the Protection of Human Rights and other acts of the European Union and international law and the practice of the European Court of Human Rights and the European Court of Justice examining cases on defending patients' rights as well have been analysed. The work reveals peculiarities of patients' rights regulations in the acquis communautaire of the European Union. It could be stated that these acts of law do not directly specify patients' rights as separate personal rights. The following patients' rights could generaly be emphasized: right to get service with appropriate level of carefulness, right to safe healthcare, right to access to information and that information will not be disclosed, right to get personal treatment method and other rights. The regulation of all these rights in international law has to be transferred to national law. The most important acts of the Republic of Lithuania (RL), firstly the Constitution of RL, the Civil Code of RL, Patients' Rights and the law of the remuneration of health harm of RL have been analysed in this aspect in this work. The problems of implementing patients' rights in Lithuania have also been revealed in this work. It shows that patients are displeased with lack of doctors' attention, do not trust a doctor treating them, get little information about the development of an illness, their time is not respected and their right to choose a doctor although stated in the law is not implemented in practice. Right to confidentiality is regulated according to the Civil Code of RL, but patients think that in practice confidential information is not secured enough. Having analysed acts of law of RL and practice of the courts of RL it has been established that for example, right to appeal is implemented only partly, because almost half patients do not know where to appeal when they are not satisfied with service. Implemetation of right to compensation (remuneration of harm) is especially relevant, so this problem has been treated quite in detail. The work has analysed effectiveness of how patiens unite into public organisations and the most important aspects of this process have been emphasized. General conclusions have been formulated drawing on the done analysis and suggestion offerred about regulation of patients' rights and perfection of its implementation in Lithuania. Keywords: patient, healthcare institution, patients' rights, law acts, civil responsibility.
Essential changes in the society that occurred in the second half of the 20th century – the democratization processes, penetration of market relationships into medicine, application of new technologies in diagnostics and treatment, limited healthcare resources – were directly related to the recognition of patients' rights and liberties. The aim of the study was to evaluate the expression of patients' rights through physician-patient relationships in inpatient personal healthcare units. Physicians' and patients' opinion about assurance of patients' right to information and patients participation in decision-making was evaluated in this dissertation. The associations of patients' social and demographic characteristics with the extent to which they are informed about their disease, the results of medical examinations, methods of treatment, possible treatment outcomes and participation in decision-making were analyzed. Physicians' and patients' attitudes towards mutual trust and confidentiality assurance in inpatients personal healthcare units were compared. Physicians' and patients' opinion about regulated provision of patients' right to State-guaranteed free healthcare was revealed. This dissertation not only evaluates patients' opinion about the assurance of their rights in inpatient personal healthcare units, but also discloses problems that physicians face when trying to implement patients' rights regulated by the Law of the Republic of Lithuania. The study not only emphasizes limitations and restraints of patients' rights, but also points out insufficient actions of the State in ensuring real and effective protection of patients' rights.
Essential changes in the society that occurred in the second half of the 20th century – the democratization processes, penetration of market relationships into medicine, application of new technologies in diagnostics and treatment, limited healthcare resources – were directly related to the recognition of patients' rights and liberties. The aim of the study was to evaluate the expression of patients' rights through physician-patient relationships in inpatient personal healthcare units. Physicians' and patients' opinion about assurance of patients' right to information and patients participation in decision-making was evaluated in this dissertation. The associations of patients' social and demographic characteristics with the extent to which they are informed about their disease, the results of medical examinations, methods of treatment, possible treatment outcomes and participation in decision-making were analyzed. Physicians' and patients' attitudes towards mutual trust and confidentiality assurance in inpatients personal healthcare units were compared. Physicians' and patients' opinion about regulated provision of patients' right to State-guaranteed free healthcare was revealed. This dissertation not only evaluates patients' opinion about the assurance of their rights in inpatient personal healthcare units, but also discloses problems that physicians face when trying to implement patients' rights regulated by the Law of the Republic of Lithuania. The study not only emphasizes limitations and restraints of patients' rights, but also points out insufficient actions of the State in ensuring real and effective protection of patients' rights.
The dissertation analyses the impact of the internal market freedoms and competition rules of the European Union on the organisation and regulation of the Lithuanian system of health protection. Under the Treaty on the Functioning of the EU, the Member States are primarily responsible for the organisation and delivery of health services and medical care. The EU competence in the field of public health is only supportive. However, over the years, the Court of Justice of the EU has developed a body of case law applying the EU internal market freedoms and competition rules in this field. The dissertation examines how the EU internal market freedoms and competition rules have affected the organisation and regulation of the Lithuanian system of health protection: what specific subjective rights have been granted to private individuals due to the operation of these provisions of EU law ('individual v public authority' level), as well as what other changes in the regulation of the system are driven by these provisions. Having identified this specific legal impact of the provisions of EU law, the dissertation further assesses whether Lithuania's competence to organise and regulate its system of health protection has as a result been restricted (the EU level v the national level). In order to answer the questions raised in the dissertation, the case law in the field of public health of the EU courts, the Constitutional Court of the Republic of Lithuania, the Supreme Administrative Court of Lithuania and documents of other EU and Lithuanian authorities are analysed in detail.
The dissertation analyses the impact of the internal market freedoms and competition rules of the European Union on the organisation and regulation of the Lithuanian system of health protection. Under the Treaty on the Functioning of the EU, the Member States are primarily responsible for the organisation and delivery of health services and medical care. The EU competence in the field of public health is only supportive. However, over the years, the Court of Justice of the EU has developed a body of case law applying the EU internal market freedoms and competition rules in this field. The dissertation examines how the EU internal market freedoms and competition rules have affected the organisation and regulation of the Lithuanian system of health protection: what specific subjective rights have been granted to private individuals due to the operation of these provisions of EU law ('individual v public authority' level), as well as what other changes in the regulation of the system are driven by these provisions. Having identified this specific legal impact of the provisions of EU law, the dissertation further assesses whether Lithuania's competence to organise and regulate its system of health protection has as a result been restricted (the EU level v the national level). In order to answer the questions raised in the dissertation, the case law in the field of public health of the EU courts, the Constitutional Court of the Republic of Lithuania, the Supreme Administrative Court of Lithuania and documents of other EU and Lithuanian authorities are analysed in detail.
The dissertation analyses the impact of the internal market freedoms and competition rules of the European Union on the organisation and regulation of the Lithuanian system of health protection. Under the Treaty on the Functioning of the EU, the Member States are primarily responsible for the organisation and delivery of health services and medical care. The EU competence in the field of public health is only supportive. However, over the years, the Court of Justice of the EU has developed a body of case law applying the EU internal market freedoms and competition rules in this field. The dissertation examines how the EU internal market freedoms and competition rules have affected the organisation and regulation of the Lithuanian system of health protection: what specific subjective rights have been granted to private individuals due to the operation of these provisions of EU law ('individual v public authority' level), as well as what other changes in the regulation of the system are driven by these provisions. Having identified this specific legal impact of the provisions of EU law, the dissertation further assesses whether Lithuania's competence to organise and regulate its system of health protection has as a result been restricted (the EU level v the national level). In order to answer the questions raised in the dissertation, the case law in the field of public health of the EU courts, the Constitutional Court of the Republic of Lithuania, the Supreme Administrative Court of Lithuania and documents of other EU and Lithuanian authorities are analysed in detail.
