OUTCOMES OF PRIMARY CARE REFORMS AND THE NEW CHALLENGES FACING ROMANIA

1. OUTCOMES OF PRIMARY CARE REFORMS ANDTHE NEW CHALLENGES FACING ROMANIA Dr. George Haber President of Romanian Society of General Practicioners and Family Medicine

2. Development outcomes and goals : rural service and infrastructure child health health system performance population and reproductive health

3. Health care reforms in Romania started late compared with other Central and East European countries. Unfavorable socioeconomic circumstances. The power of the hospital.

4. GOALS: To improve the quality of general practice in Romania. To stimulate the development of Family Medicine teaching in our country, the necessary skills, and up-to-date clinical knowledge.

5. OUTCOMES: Fast access to care when it is needed. High quality healthcare system, improving access is now a top priority for Romanian health policy. The impact of advanced access on continuous care, a higher priority for many people. Resistance to change. Set up a system to monitor the performance of primary care organizations and are intended to reflect the progress of primary care.

6. There are many factors {for example geographic, financial, socioeconomic, educational, cultural, technological} known to have an influence on how pacients access services, the interplay of these factors can be very complex, and access must be evaluated in the context of differing perspective health needs.

7. The greater health problem of deprived community are threatened by lack of available local primary care. Secondly, one can try to maximize the output of existing resources by exchanging, the skill mix of professional teams. Thirdly, one can try to target resources at under-served areas and/or vulnerable or underserved population group.

8. Improve specific aspects of access for example continuity of care. Needs based equity is very difficult to measure, and adaptation with geographical and also within different sociocultural and economic subgroups. Services around locally defined needs appears to be effective in improving access for marginalised groups.

9. The Romanian GP’s, do not have the answer to the problems currently facing rural health, so there is need for the development and support of health teams with diverse skills. In Romania the majority of the population, is located in rural areas, where there may be a lack of basic health and they often have limited access to modern medical services.

10. Rural health services requires proportional resources and fewer staff than urban health services.

11. The health of rural people is affected by social, cultural and economics factors the major detriment comes from lack of resources and poverty. In Romania, the policy on rural practice and rural health contains strategies to assist the area’s progress.

12. A combined effort to change the historical inequities faced by rural and disadvantaged community is needed through affirmative action for rural people with respect to health care.

13. The outcomes and strategies proposed: the necessary infrastructure for the implementation of comprehensive health care for rural, must be a high priority for Romanian Health Ministry. the status of rural doctors, needs to be elevated by a coordinative approach involving improved career projects education and trainings, and improved working conditions. the models of rural health services need to be evaluated and promoted in partnership with communities, and in cooperation with regional and national health authorities. the need for dedicated funding for the support of rural health care practicioners must be recognized.

14. There are significant differences on how the health care system is organized and family medicine is practiced, throughout Europe. Reform of national health systems is a common feature in Europe, given the change in demography, medical advances, health economics and patient needs and expectation of the people. Primary care provides both more cost effective and more clinically effective.

15. Europe has a variety of health care systems and diverse situations where care is provided by the GP. There are basic cultural and political differences in the societies and the populations the GP are serving. GP is a clinical discipline, which more than any other, is dependent on societal differences. The GP is the mediator between society and medicine.

16. Tomorrow’s patient will be not the same as today’s. New values, preferences and lifestyle are developing and providing a basis for the definition of new group identities. People have even higher expectations regarding the quality of life and the quality of health.

17. Socio-economic health inequalities, particularly with regard to life expectancy are challenged by major demographic, epidemiological, sociocultural, scientific and technological developments. Considerable variation within the EU, by the type of healthcare system and the demographic changes, will have major implications for healthcare in many European countries.