Ambulant (secondary) health care is the chain of health care, where specialized (secondary level) consultations of doctors specialists are rendered. In Lithuanian national health system we can mark three models (types) of institutions which render ambulant health care services, depending on organization of services and type of ownership. These institutions are: municipality clinics, rendering primary and secondary health care services (mixed institutions), municipality centres of primary health care (municipality institutions of primary health care) and private institutions of primary health care (independent contractors). This research is a way to name problems, which emerge seeking to control mixed institutions, rendering (secondary level) health care services. The aim of work: to analyse control problems of rendering ambulant health care services and propose possible ways of solutions. Methodology: to analyse ambulant services, rendered by secondary level doctors otorinolaringolists in the period 2006-01-01 – 2006-01-31, equivalence of these services to law acts and validity of tender to discharge them from the budget of compulsory health insurance allocation. Informational system data SVEIDRA of State patient fund and primary medicine documentary were analysed. Research involved three institutions (mixed clinics), rendering primary and secondary ambulant health care services in Vilnius city. These clinics had contracts with State patient fund. All chosen clinics were... [to full text]

Enhancement of the quality of outpatient services and the problems of accessibility of services become more and more important part of the health care reform. The importance of increasing the provision of the services in outpatient institutions and developing of outpatient services of physicians-specialists are the priorities in the plan of re-structuring of health care. Aim of the study. To analyze the provision and tendencies of the secondary and tertiary level outpatient services to inhabitants of the area Vilnius Territorial Patient Fund in 2003-2005. Objectives. To evaluate the provision of the secondary level outpatient services by specialty, by municipalities and age groups. To analyze the tertiary level outpatient services by municipalities. To evaluate the changes and tendencies in providing secondary and tertiary level outpatient services. Materials and methods. Analysis was done using the data of health insurance information system SVEIDRA on inhabitants registered to primary health care institutions and outpatient services provided to inhabitants of the area of Vilnius Territorial Patient Fund in 2003-2005. In order to evaluate distribution of services by municipalities, the number of outpatient services per one inhabitant, registered to primary health care institution, was calculated. Four age groups (0-5, 5-18, 18-65, over 65 years old) were chosen to analyze distribution of services by age groups. The existence of statistically significant differences was... [to full text]