Strategija primarne zdravstvene zaštite

U ruralnim ambulantama porodične medicine, dijagnostičkeusluge ugovara tim porodične medicine, aplaćaju se per capita. U ovom slučaju, potrebna su određenaprilagođavanja formule plaćanja timova porodičnemedicine.Higijensko-epidemiološki posloviOrganizacijaPotrebno je da svi domovi zdravlja u Republici Srpskojprocijene lokalne potrebe i ekonomsku opravdanostu vezi sa statusom i radom postojeće higijensko-epidemiološkeslužbe.Na osnovu konačne procjene potreba i dokazaneekonomske opravdanosti, “nova” higijensko-epidemiološkaslužba ostaje u sastavu doma zdravlja.Primarni zadaci “nove” higijensko-epidemiološkeslužbe su unapređenje i kontrola stanja higijenskih prilikana području lokalne zajednice i epidemiološko nadgledanje,preventivni rad u smislu eliminacije mogućihizvora zaraze, te kontrola i suzbijanje širenja zaraznih imasovnih nezaraznih bolesti.Ugovaranje i mehanizmi plaćanjaHigijensko-epidemiološke usluge ugovara dom zdravlja,a mogu se plaćati kombinovano: po obavljenoj usluzii prospektivnim budžetom.Osim toga, dom zdravlja može ugovarati higijensko-epidemiološkeposlove sa jedinicom lokalne samoupravei drugim pravnim i fizičkim licima na svom području.Contracting and provider payment mechanismsIn the interim period, community-based physicalrehabilitation services and mental health services will becontracted by health centres.Later on, community-based physical rehabilitationcentres and mental health centres, as independent legalentities, will autonomously contract services falling withintheir scope of responsibility.In both centres, health services falling within thescope of community-based physical rehabilitation centresand mental health centre may be paid through prospectivebudgeting.Diagnostic servicesOrganisationThe following are services most frequently providedby health centres: biochemical - haematological, RTGand ultrasound.In is necessary that all health centres in the Republicof Srpska assess their needs and economic cost-effectivenessof introduction, i. e. application of certainmedical technologies.Based on the final need assessment and cost-effectivenessof the introduction, i. e. application of medicaltechnologies, diagnostic services, which are to remainwithin health centres, will serve as a technical support toeveryday activities of family medicine teams.Rural family medicine clinics, 10 or more kilometresfrom a health centre, may have equipment for commonlaboratory services.Strategija primarne zdravstvene zaštite32The Primary Health Care Strategy