The aim of this survey was to evaluate intentions of Lithuanian physicians and medical residents to work in the European Union (EU) and other countries. The survey was performed in 2002 in the framework of the project "Health human resource development and planning in Lithuania", sponsored by Open Society Fund, Lithuania. Using the questionnaire developed by the Ministry of Labor and Solidarity of France, 242 medical residents and 497 physicians were surveyed. Survey results indicated that 60.7% of medical residents and 26.0% of physicians intended to leave for the EU or other countries. The survey also showed that the first-choice countries were United Kingdom, Germany and the Nordic countries. Almost 15.0% of medical residents and 5.0% of physicians planed to leave for the EU on permanent basis. The largest part of those who intended to leave for the EU, planned to go there after accession. It was a definitive decision of 2.5% of medical residents and 3.8% of physicians. The major reasons for leaving were higher salary, better professional possibilities and better quality of life. For medical residents a previous visit abroad for professional reasons increased the risk of working abroad significantly (OR–3.29, 95% CI 1.73–6.27). In the case of physicians, age was the factor that significantly decreased the risk (OR–0.94, 95% CI 0.91–0.96); however having friends abroad increased the risk by more than three times (OR–3.22, 95% CI 1.91–5.42). In order to observe the possible migration to the EU or other countries, the survey should be repeated every three-four years.
The aim of this survey was to evaluate intentions of Lithuanian physicians and medical residents to work in the European Union (EU) and other countries. The survey was performed in 2002 in the framework of the project "Health human resource development and planning in Lithuania", sponsored by Open Society Fund, Lithuania. Using the questionnaire developed by the Ministry of Labor and Solidarity of France, 242 medical residents and 497 physicians were surveyed. Survey results indicated that 60.7% of medical residents and 26.0% of physicians intended to leave for the EU or other countries. The survey also showed that the first-choice countries were United Kingdom, Germany and the Nordic countries. Almost 15.0% of medical residents and 5.0% of physicians planed to leave for the EU on permanent basis. The largest part of those who intended to leave for the EU, planned to go there after accession. It was a definitive decision of 2.5% of medical residents and 3.8% of physicians. The major reasons for leaving were higher salary, better professional possibilities and better quality of life. For medical residents a previous visit abroad for professional reasons increased the risk of working abroad significantly (OR–3.29, 95% CI 1.73–6.27). In the case of physicians, age was the factor that significantly decreased the risk (OR–0.94, 95% CI 0.91–0.96); however having friends abroad increased the risk by more than three times (OR–3.22, 95% CI 1.91–5.42). In order to observe the possible migration to the EU or other countries, the survey should be repeated every three-four years.
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 inter-professional cooperation between pharmacists and physicians is becoming of crucial importance in ensuring safe and appropriate healthcare services. A solid amount of evidences suggests that this collaboration is beneficial for all participants and provide benefits for patient However, this collaboration is facing challenges and obstacles for applying it in wide practice. Nation and international surveys suggest that both physicians and pharmacists do not avail themselves of cooperation opportunities. The aim of the study was to evaluate pharmacists experience and attitude towards collaboration between physicians and pharmacy professionals working in community pharmacies. Methods: The qualitative method with mixed data collection strategy has been used. It has focused on collaboration between pharmacists (with work experience of 15 years and more) and physicians. The focus group discussion has been carried out with four pharmacy professionals constantly cooperating with physicians. The vignette survey was performed with 21 pharmacy professionals. The data collection was performed from December 2014 to September 2015. Results: Our findings suggest that pharmacists are involved in communication with physicians quite often. However, these interactions are sufficiently short and usually limited to a phone call dealing with a wrong prescription or medication dosage prescribed to the patient. It means that the collaboration is still not so efficient and effective teamwork. Physicians communicate with pharmacists for getting information regarding different aspects of medicines, i.e. dosage, international name, manufacturer, etc. It should be noted, that only a small number of pharmacists maintain regular contacts with physicians and regularly discuss developments, legislative changes, medicines and their benefits to the patient. The respondents believe, that effective cooperation between physicians and pharmacists is hampered by professional prejudices, lack of a common goal, underestimation of the pharmacist knowledge and skills, etc. Insights: In summary, the results suggest that current inter-professional collaboration between physicians and pharmacist is not based on the efficient and effective teamwork. However, the majority of interviewed pharmaceutical professionals identified the benefits of cooperation. Moreover, it was mentioned, that the given field requires changes, new approaches and initiatives in order to ensure an efficient and effective service delivery to patients.
The inter-professional cooperation between pharmacists and physicians is becoming of crucial importance in ensuring safe and appropriate healthcare services. A solid amount of evidences suggests that this collaboration is beneficial for all participants and provide benefits for patient However, this collaboration is facing challenges and obstacles for applying it in wide practice. Nation and international surveys suggest that both physicians and pharmacists do not avail themselves of cooperation opportunities. The aim of the study was to evaluate pharmacists experience and attitude towards collaboration between physicians and pharmacy professionals working in community pharmacies. Methods: The qualitative method with mixed data collection strategy has been used. It has focused on collaboration between pharmacists (with work experience of 15 years and more) and physicians. The focus group discussion has been carried out with four pharmacy professionals constantly cooperating with physicians. The vignette survey was performed with 21 pharmacy professionals. The data collection was performed from December 2014 to September 2015. Results: Our findings suggest that pharmacists are involved in communication with physicians quite often. However, these interactions are sufficiently short and usually limited to a phone call dealing with a wrong prescription or medication dosage prescribed to the patient. It means that the collaboration is still not so efficient and effective teamwork. Physicians communicate with pharmacists for getting information regarding different aspects of medicines, i.e. dosage, international name, manufacturer, etc. It should be noted, that only a small number of pharmacists maintain regular contacts with physicians and regularly discuss developments, legislative changes, medicines and their benefits to the patient. The respondents believe, that effective cooperation between physicians and pharmacists is hampered by professional prejudices, lack of a common goal, underestimation of the pharmacist knowledge and skills, etc. Insights: In summary, the results suggest that current inter-professional collaboration between physicians and pharmacist is not based on the efficient and effective teamwork. However, the majority of interviewed pharmaceutical professionals identified the benefits of cooperation. Moreover, it was mentioned, that the given field requires changes, new approaches and initiatives in order to ensure an efficient and effective service delivery to patients.
The purpose of the study - to determine the perspectives of medical staff in relation to health care quality improvement in Ukmerge Hospital. Methods. Analysis of hospital organizational activity was performed. All physicians and nurses were questioned by an anonymous questionnaire (n=231). 187 of questionnaires were completed and returned by the respondents. The response rate was 76,2 percent. The data was analyzed using statistical package SPSS 10.0 for Windows. The associations between the variables were measured using the Chi-squared test. Results: 63.2 percent of medical staff were informed about the quality tasks in the unit, 46.6 percent of them know the quality tasks in the hospital and 11.8 percent are familiar with the national health care quality legislation. The acknowledgments from the patients and improvement of work conditions, recognition from leaders and colleagues give physicians and nurses (76.3 – 61.8 percent) an important incentive to work better. Professional competency with knowledge improvement (67.4 percent) and personal employee's responsibility (67.9 percent) were the main value enshrined in the organization. By the opinion of 40.9 percent of respondents, patients can trust absolutely in the services or hospital. Work motivation from leaders is appreciable for every second of respondents. Conclusions. Knowledge of medical staff about the health care service quality improvement system was the most remarkable in the unit. The scheduled inspections were recognized as the main function of local audit group in the hospital. Other tasks of audit group such as analysis of patients' complaints, implementation of documentation and purposive inspections were significantly better known for physicians than for nurses. The convenient knowledge improvement system and material inducements, decreasing complexity of work and higher safety would be the main factors that motivate medical staff forward the higher quality in practice. Nurses significantly better than physicians qualify professional activity and notice sufficient patients' supply with treatment and care devices. Physicians are more concerned in high professional qualification and its influence to patients' satisfaction with care than nurses. Recommendations. A seminar for medical staff is recommended in order to increase the knowledge of physicians and nurses about the national and local policy of health care quality. The purposive meetings with medical staff in practical environment would serve for effective prevention of undesirable events. Motivation system of medical personnel is essential for service improvement.
The purpose of the study - to determine the perspectives of medical staff in relation to health care quality improvement in Ukmerge Hospital. Methods. Analysis of hospital organizational activity was performed. All physicians and nurses were questioned by an anonymous questionnaire (n=231). 187 of questionnaires were completed and returned by the respondents. The response rate was 76,2 percent. The data was analyzed using statistical package SPSS 10.0 for Windows. The associations between the variables were measured using the Chi-squared test. Results: 63.2 percent of medical staff were informed about the quality tasks in the unit, 46.6 percent of them know the quality tasks in the hospital and 11.8 percent are familiar with the national health care quality legislation. The acknowledgments from the patients and improvement of work conditions, recognition from leaders and colleagues give physicians and nurses (76.3 – 61.8 percent) an important incentive to work better. Professional competency with knowledge improvement (67.4 percent) and personal employee's responsibility (67.9 percent) were the main value enshrined in the organization. By the opinion of 40.9 percent of respondents, patients can trust absolutely in the services or hospital. Work motivation from leaders is appreciable for every second of respondents. Conclusions. Knowledge of medical staff about the health care service quality improvement system was the most remarkable in the unit. The scheduled inspections were recognized as the main function of local audit group in the hospital. Other tasks of audit group such as analysis of patients' complaints, implementation of documentation and purposive inspections were significantly better known for physicians than for nurses. The convenient knowledge improvement system and material inducements, decreasing complexity of work and higher safety would be the main factors that motivate medical staff forward the higher quality in practice. Nurses significantly better than physicians qualify professional activity and notice sufficient patients' supply with treatment and care devices. Physicians are more concerned in high professional qualification and its influence to patients' satisfaction with care than nurses. Recommendations. A seminar for medical staff is recommended in order to increase the knowledge of physicians and nurses about the national and local policy of health care quality. The purposive meetings with medical staff in practical environment would serve for effective prevention of undesirable events. Motivation system of medical personnel is essential for service improvement.
Public services in the health sector are – one of the main activities to ensure the municipal functions. One way to modernize public services is through information and communication technologies. Expanding information and communication technologies provide opportunities for health sector efficiency. Lithuania has developed a legal framework for e. health system, introduced e. health concept, regulated e. health system functions, approved and established requirements for information systems implementation in healthcare institutions, implemented state and regional investment projects, and is pursuing other developments in health information system. Health care institutions faces failures in e. health project implementation: poor job planning, staff resistance to innovation, medical personnel's lack of computer literacy. The problem of the research: what measures of public services modernization, for developing e. health system, help to ensure the effective health policy development in public institutions "Tauragė Hospital"and "Šilalė Hospital"? Based on the scientific literature analysis and empirical research the Master's thesis suggests improvement solutions for modernization of public services in implementing e. health system in public institutions "Tauragė Hospital"and "Šilalė Hospital". To achieve the aim of the research, the following tasks were formulated: 1) to review literature on public services modernization in the context of different approaches; 2) to analyse theoretical bases of e. health services development; 3) to identify problems of e. health system development in Lithuania; 4) to investigate views and experiences of physicians and patients on the public services modernization in public institutions "Tauragė Hospital"and "Šilalė Hospital". These research methods were employed: scientific literature review, document analysis descriptive and comparative, analysis of qualitative and quantitative data. The research results showed that physicians and patients in public institutions "Tauragė Hospital"and "Šilalė Hospital" uses a variety of tools within e. health system. The advantages of e. health system for physicians are identified: speed, convenient access to databases that store previous health events and past medical treatments. The main disadvantages are apparent in the investigated health facilities are: lack of unified e. health system, physicians are using different information systems, not all records are accessible, medical institutions are not fully integrated into the system, the IT system does not work smoothly, it is difficult to navigate. Patients usually face the following problems: too little information about use of e. health system is provided, the patients struggle with computer literacy problems, which are determined by socio-demographic characteristics. To solve the problems, physicians in public institutions should be encouraged to disseminate the information about health services, share leaflets or brochures with patient containing details of the e. health system, its benefits and opportunities for patients. Patients in public institutions are suggested to increase their computer literacy, enabling quick and easy use of e. health services. The thesis consists of an introduction, four parts, conclusions and recommendations. In the first part of the work the problems of public services modernization are analysed. In the second part of the work theoretical base of e. health services development presented, including the e. health concept, advantages and disadvantages of e. health services, opportunities and threats of modernization. In the third part of the work research methodology for e. health services modernization analysis is described. The fourth part examines attitudes of physicians and patients about the modernization of public services in public institutions "Tauragė Hospital"and "Šilalė Hospital". The work ends with conclusions and recommendations. The project includes 12 tables, 19 illustrations, 2 annexes. 48 sources of scientific literature were used as well as 6 pieces of legislation and sources of data
Public services in the health sector are – one of the main activities to ensure the municipal functions. One way to modernize public services is through information and communication technologies. Expanding information and communication technologies provide opportunities for health sector efficiency. Lithuania has developed a legal framework for e. health system, introduced e. health concept, regulated e. health system functions, approved and established requirements for information systems implementation in healthcare institutions, implemented state and regional investment projects, and is pursuing other developments in health information system. Health care institutions faces failures in e. health project implementation: poor job planning, staff resistance to innovation, medical personnel's lack of computer literacy. The problem of the research: what measures of public services modernization, for developing e. health system, help to ensure the effective health policy development in public institutions "Tauragė Hospital"and "Šilalė Hospital"? Based on the scientific literature analysis and empirical research the Master's thesis suggests improvement solutions for modernization of public services in implementing e. health system in public institutions "Tauragė Hospital"and "Šilalė Hospital". To achieve the aim of the research, the following tasks were formulated: 1) to review literature on public services modernization in the context of different approaches; 2) to analyse theoretical bases of e. health services development; 3) to identify problems of e. health system development in Lithuania; 4) to investigate views and experiences of physicians and patients on the public services modernization in public institutions "Tauragė Hospital"and "Šilalė Hospital". These research methods were employed: scientific literature review, document analysis descriptive and comparative, analysis of qualitative and quantitative data. The research results showed that physicians and patients in public institutions "Tauragė Hospital"and "Šilalė Hospital" uses a variety of tools within e. health system. The advantages of e. health system for physicians are identified: speed, convenient access to databases that store previous health events and past medical treatments. The main disadvantages are apparent in the investigated health facilities are: lack of unified e. health system, physicians are using different information systems, not all records are accessible, medical institutions are not fully integrated into the system, the IT system does not work smoothly, it is difficult to navigate. Patients usually face the following problems: too little information about use of e. health system is provided, the patients struggle with computer literacy problems, which are determined by socio-demographic characteristics. To solve the problems, physicians in public institutions should be encouraged to disseminate the information about health services, share leaflets or brochures with patient containing details of the e. health system, its benefits and opportunities for patients. Patients in public institutions are suggested to increase their computer literacy, enabling quick and easy use of e. health services. The thesis consists of an introduction, four parts, conclusions and recommendations. In the first part of the work the problems of public services modernization are analysed. In the second part of the work theoretical base of e. health services development presented, including the e. health concept, advantages and disadvantages of e. health services, opportunities and threats of modernization. In the third part of the work research methodology for e. health services modernization analysis is described. The fourth part examines attitudes of physicians and patients about the modernization of public services in public institutions "Tauragė Hospital"and "Šilalė Hospital". The work ends with conclusions and recommendations. The project includes 12 tables, 19 illustrations, 2 annexes. 48 sources of scientific literature were used as well as 6 pieces of legislation and sources of data
Public services in the health sector are – one of the main activities to ensure the municipal functions. One way to modernize public services is through information and communication technologies. Expanding information and communication technologies provide opportunities for health sector efficiency. Lithuania has developed a legal framework for e. health system, introduced e. health concept, regulated e. health system functions, approved and established requirements for information systems implementation in healthcare institutions, implemented state and regional investment projects, and is pursuing other developments in health information system. Health care institutions faces failures in e. health project implementation: poor job planning, staff resistance to innovation, medical personnel's lack of computer literacy. The problem of the research: what measures of public services modernization, for developing e. health system, help to ensure the effective health policy development in public institutions "Tauragė Hospital"and "Šilalė Hospital"? Based on the scientific literature analysis and empirical research the Master's thesis suggests improvement solutions for modernization of public services in implementing e. health system in public institutions "Tauragė Hospital"and "Šilalė Hospital". To achieve the aim of the research, the following tasks were formulated: 1) to review literature on public services modernization in the context of different approaches; 2) to analyse theoretical bases of e. health services development; 3) to identify problems of e. health system development in Lithuania; 4) to investigate views and experiences of physicians and patients on the public services modernization in public institutions "Tauragė Hospital"and "Šilalė Hospital". These research methods were employed: scientific literature review, document analysis descriptive and comparative, analysis of qualitative and quantitative data. The research results showed that physicians and patients in public institutions "Tauragė Hospital"and "Šilalė Hospital" uses a variety of tools within e. health system. The advantages of e. health system for physicians are identified: speed, convenient access to databases that store previous health events and past medical treatments. The main disadvantages are apparent in the investigated health facilities are: lack of unified e. health system, physicians are using different information systems, not all records are accessible, medical institutions are not fully integrated into the system, the IT system does not work smoothly, it is difficult to navigate. Patients usually face the following problems: too little information about use of e. health system is provided, the patients struggle with computer literacy problems, which are determined by socio-demographic characteristics. To solve the problems, physicians in public institutions should be encouraged to disseminate the information about health services, share leaflets or brochures with patient containing details of the e. health system, its benefits and opportunities for patients. Patients in public institutions are suggested to increase their computer literacy, enabling quick and easy use of e. health services. The thesis consists of an introduction, four parts, conclusions and recommendations. In the first part of the work the problems of public services modernization are analysed. In the second part of the work theoretical base of e. health services development presented, including the e. health concept, advantages and disadvantages of e. health services, opportunities and threats of modernization. In the third part of the work research methodology for e. health services modernization analysis is described. The fourth part examines attitudes of physicians and patients about the modernization of public services in public institutions "Tauragė Hospital"and "Šilalė Hospital". The work ends with conclusions and recommendations. The project includes 12 tables, 19 illustrations, 2 annexes. 48 sources of scientific literature were used as well as 6 pieces of legislation and sources of data
Public services in the health sector are – one of the main activities to ensure the municipal functions. One way to modernize public services is through information and communication technologies. Expanding information and communication technologies provide opportunities for health sector efficiency. Lithuania has developed a legal framework for e. health system, introduced e. health concept, regulated e. health system functions, approved and established requirements for information systems implementation in healthcare institutions, implemented state and regional investment projects, and is pursuing other developments in health information system. Health care institutions faces failures in e. health project implementation: poor job planning, staff resistance to innovation, medical personnel's lack of computer literacy. The problem of the research: what measures of public services modernization, for developing e. health system, help to ensure the effective health policy development in public institutions "Tauragė Hospital"and "Šilalė Hospital"? Based on the scientific literature analysis and empirical research the Master's thesis suggests improvement solutions for modernization of public services in implementing e. health system in public institutions "Tauragė Hospital"and "Šilalė Hospital". To achieve the aim of the research, the following tasks were formulated: 1) to review literature on public services modernization in the context of different approaches; 2) to analyse theoretical bases of e. health services development; 3) to identify problems of e. health system development in Lithuania; 4) to investigate views and experiences of physicians and patients on the public services modernization in public institutions "Tauragė Hospital"and "Šilalė Hospital". These research methods were employed: scientific literature review, document analysis descriptive and comparative, analysis of qualitative and quantitative data. The research results showed that physicians and patients in public institutions "Tauragė Hospital"and "Šilalė Hospital" uses a variety of tools within e. health system. The advantages of e. health system for physicians are identified: speed, convenient access to databases that store previous health events and past medical treatments. The main disadvantages are apparent in the investigated health facilities are: lack of unified e. health system, physicians are using different information systems, not all records are accessible, medical institutions are not fully integrated into the system, the IT system does not work smoothly, it is difficult to navigate. Patients usually face the following problems: too little information about use of e. health system is provided, the patients struggle with computer literacy problems, which are determined by socio-demographic characteristics. To solve the problems, physicians in public institutions should be encouraged to disseminate the information about health services, share leaflets or brochures with patient containing details of the e. health system, its benefits and opportunities for patients. Patients in public institutions are suggested to increase their computer literacy, enabling quick and easy use of e. health services. The thesis consists of an introduction, four parts, conclusions and recommendations. In the first part of the work the problems of public services modernization are analysed. In the second part of the work theoretical base of e. health services development presented, including the e. health concept, advantages and disadvantages of e. health services, opportunities and threats of modernization. In the third part of the work research methodology for e. health services modernization analysis is described. The fourth part examines attitudes of physicians and patients about the modernization of public services in public institutions "Tauragė Hospital"and "Šilalė Hospital". The work ends with conclusions and recommendations. The project includes 12 tables, 19 illustrations, 2 annexes. 48 sources of scientific literature were used as well as 6 pieces of legislation and sources of data
This Master Thesis analyzes and evaluates the efficiency of colorectal cancer preventative program in theprimary health care institution in the district of Jurbarkas according to the point of view by physician and patient. It also analyzes Lithuanian and European epidemiological situation of colorectal cancer. Legislation and documents of the program are also analyzed. Compared the programs of colorectal cancer preventative program in Lithuania anf European union countries. Analyzed database about the implementation of the program in theprimary health care institution from the phusicians and patiens viewpoint.
This Master Thesis analyzes and evaluates the efficiency of colorectal cancer preventative program in theprimary health care institution in the district of Jurbarkas according to the point of view by physician and patient. It also analyzes Lithuanian and European epidemiological situation of colorectal cancer. Legislation and documents of the program are also analyzed. Compared the programs of colorectal cancer preventative program in Lithuania anf European union countries. Analyzed database about the implementation of the program in theprimary health care institution from the phusicians and patiens viewpoint.
This abrupt increase in demands to a physician and his legal responsibility was not preceded by a related increase in his abilities and resources necessary to adapt to the change in law. This caused the set off of unintended side-effects, which arise from doctors' intent to defend themselves from probable legal prosecution and which brought about a decrease of the quality of health care. Multiple manifestations of defensive medicine and its consequences for health care are reviewed. Ways and prospects for solutions to the problem of "defensive medicine" (especially, ensuring feasibility of related legal provisions) are examined.
