Darbo tikslas. Išanalizuoti asmens sveikatos priežiūros įstaigų bendradarbiavimo galimybes su įstaigų veiklą kontroliuojančiomis valstybės institucijomis. Metodika. 2009 m. gruodžio – 2010 m. vasario mėn. buvo atlikta Kauno apskrities asmens sveikatos priežiūros įstaigų administracinį darbą dirbančių darbuotojų anketinė apklausa. Anketas užpildė ir grąžino 68 respondentai iš 55 Kauno apskrityje veikiančių asmens sveikatos priežiūros įstaigų (atsako dažnis 66,7%). Statistiniams ryšiams įvertinti naudotas Chi kvadrato (χ2 ) kriterijus, Z-kriterijus taikytas lyginant dviejų proporcijų lygybę. Rodiklių skirtumai laikyti statistiškai reikšmingais, kai p<0,05. Rezultatai. Kauno apskrities asmens sveikatos priežiūros įstaigų darbuotojai (86,8 proc.) dažniausiai bendradarbiauja su Teritorinėmis ligonių kasomis, mažiausiai - su Lietuvos medicinos etikos komitetu (4,4 proc.). Asmens sveikatos priežiūros įstaigų darbuotojai įstaigų veiklą kontroliuojančių valstybės institucijų darbą vertino: labai gerai 5,9 proc., gerai 38,2 proc., vidutiniškai 51,5 proc., blogai 4,4 proc. Bendradarbiavimas su įstaigų veiklą kontroliuojančiomis valstybės institucijomis dažniausiai vyksta kelis kartus per mėnesį. Dažniausiai informacija įstaigų veiklą kontroliuojančioms valstybės institucijomis yra perduodama el. paštu. Vyresnio amžiaus darbuotojai, bei vyrai, dažniau bendradarbiauja neformalioje aplinkoje su kitų asmens sveikatos priežiūros įstaigų darbuotojais ir su įstaigų veiklą kontroliuojančiomis... [toliau žr. visą tekstą] / Aim of the study. To analyze the opportunities of co-operation between health care institutions and the state controlling institutions. Methods. The survey of workers of Kaunas county health care institutions was accomplished during 2009 December - 2010 February. Questionnaires were filled-in and returned by 68 respondents of the 55 Kaunas county health care institutions (response rate 66,7%). For the assessment of the statistical relationships Chi square (χ2) criteria was used; Z-test was used for the comparison of two proportions. Differences were considered as statistically significant at p<0,05 level. Results. Kaunas county health care workers (86,8%) mostly collaborate with regional sickness insurance funds, at least with Lithuanian medical ethics committee (4,4%). Health care workers assess work of the state controlling institutions: very good (5,9%), well (38,2%), an average (51,5%), negative (4,4%). Cooperation with the state controlling institutions is preceded several times a month. Information is often transferred by e-mail to the state controlling institutions. Older workers and men often co-operate with the state controlling institutions in non-formal way. Respondents who are satisfied in supervising with the state controlling institutions are more satisfied with aspects of the issues. Only one third of the respondents received information from the state controlling institutions timely. Respondents under the age of 35 and over the age of 43 years were satisfied... [to full text]

Magistro baigiamajame darbe išanalizuoti LR egzistuojančių viešų ir privačių sveikatos priežiūros įstaigų veiklos skirtumai bei jų sąveiką. Ištirti tokie viešųjų ir privačių sveikatos priežiūros sektorių aspektai: sveikatos priežiūros sektoriai patys savaime, šių įstaigų institucinis išsidėstymas, teisinis reglamentavimas, finansavimas, konkurencingumas, prieinamumas pacientui. Pirmojoje darbo dalyje yra aptarta Lietuvos nacionalinės sveikatos sistema, kaip turinti vienyti viešąsias ir privačiąsias sveikatos priežiūros įstaigas, aptarta jos bendroji charakteristika. Antrojoje dalyje išsamiai išnagrinėtos, suklasifikuotos sveikatos priežiūros įstaigos, aptarta jų priklausomybė viena nuo kitos. Trečiojoje darbo dalyje kaip atskiros grupės išskirtos privačios ir viešosios sveikatos priežiūros: aptarta jų sąveika, pagrindiniai skirtumai, pamatiniai teisinio reglamentavimo ypatumai. Paskutinė ketvirta lyginamoji darbo dalis leido surasti tuos taškus, per kuriuos viešasis sveikatos priežiūros sektorius galėtų bendradarbiauti su privačiu. Palyginta šių sektorių finansavimo bazė, surasta papildoma alternatyva papildomojo sveikatos draudimo pavidalu. Kadangi sveiktos priežiūros sektoriuje centrinė figūra vis tik turi būti pacientas, pateiktas ir jo požiūris į privatų ir viešąjį sveikatos priežiūros sektorius, šių sektorių vertinimas. / The distinction and interface of health care institutions of Lithuania Republic are analyzed in this final master’s work Such public ant private health care institutions aspects are analyzed: health care institutions by themselves, deployment of these institutions, their legal regulation, sponsorship, competitive ability, accessibility for the patients. The first part of the work is concerned about national health care system of Lithuania, which must unify public and private health care institutions. The common characteristics of this system are discussed. The second part thoroughly reveals and classifies health care institutions; knock about their dependence on each other. In the third part as separate groups are divided private and public health care institutions: their interaction, main differences and basic legal regulation principles are discussed. The last fourth comparative part enabled to find those points, which could help for private health care sector to collaborate with public one. The comparison of financial basis of those sectors, allowed to found an additional assurance alternative. Since the patient is the central figure in a health care sector, his attitude towards the private and public health care institutions, and those sectors valuation is represented.

Management of Public Health The assessment of patients right to choose primary health care institution in the context of competition Simona Stulpinaitytė Supervisor Prof., dr. Irayda Jakušovaitė Department of Social Medicine, Faculty of Public Health, Kaunas University of Medicine. Kaunas; 2005. 65 p. Aim of the study. To assess and compare patients possibility to use their right to choose primary health care institutions in the context of competition. Objectives. 1) To assess factors who determine the choice of private or public primary health care institution; 2) To compare patients opinion about services that are provided in public and private health care institutions; 3) To compare ethical problems in healh care in micro (doctor – pacient) level in public and private health care institutions. Methods. During the survey there were questioned 380 patients at the public and private health care institutions in Garliava. Response rate in public health care institutions was 81% and in private health care institution it was 84%. Statistical analysis was carried out using statistical package for social sciences - SPSS 11.5 for Windows. Associations between the variables were tested by Chi squared. Patients answers under provided services in public and private health care institutions were analyzed by measuring means that were compared using the Stujdent test (t). Significance level (p) less than 0,05 was considered as statistically significant (p<0,05). Results. The most... [to full text]

The importance of health care institutions’ management is accepted about 20 years ago. First in Lithuania the post of hospital administrator was established in Hospital of Kaunas University of Medicine in 1996. It is the first investigation of the expediency’s appreciation of hospital administrator’s post in Lithuania. Aim of the study: to evaluate the appreciation of the hospital administrator’s post. Objectives: 1) To analyse papers influencing on hospital administrator’s job. 2) To investigate and compare the opinion of hospital administrators and departments’ chiefs about the necessity of manager in hospital. Methods: The study consists of the responses of 34 chiefs and 54 administrators of departments of Kaunas Medical University Hospital. We asked questions of chiefs and administrators to determine the necessity of administrator’s role in health care organization, what functions hospital administrators should do. The administrators’ response rate was 65% (35 of 54), the chiefs’ rate was 79% (27 of 35). There were used T and Chi-square tests, hospital administrators were compare to chiefs of departments. In all instances statistical significance is set at 0.05 level. Results: There is done the analysis of health care institutions’ management and roles of hospital administrator. By investigation in Hospital of Kaunas University of Medicine all chiefs of departments (100%) and almost all hospital administrators (97%) predicate that the post of hospital administrator is... [to full text]

Magistro baigiamasis darbas sudarytas iš trijų pagrindinių dalių. Pirmoje dalyje analizuojami teoriniai vidaus medicininio audito sveikatos priežiūros įstaigose aspektai bei modeliai, nagrinėjamas vidaus medicininio audito teisinis reglamentavimas Lietuvoje. Antroje dalyje analizuojama VšĮ Respublikinės Panevėžio ligoninės vidaus medicininio audito veikla 2010 – 2013 m., jos organizavimas ir vykdymas. Trečiojoje darbo dalyje įvertinama vidaus medicininio audito veikla Respublikinėje Panevėžio ligoninėje vidaus medicinos auditorių ir konsultantų požiūriu. Magistro baigiamojo darbo pabaigoje, remiantis vidaus medicininio audito 2010 – 2013 m. veiklos analize ir kokybinio tyrimo rezultatais, pateikiamos išvados ir rekomendacijos Respublikinės Panevėžio ligoninės vidaus medicininio audito veiklos gerinimui. / The Master’s Thesis consists of three basic parts. In the first part theoretical aspects and models of internal medical audit in health care institutions are analysed. The first part also deals with legal regulation of internal medical audit in Lithuania. In the second part organization and implementation of internal medical audit activity in the Public Institution Panevėžys Republican Hospital during the period of 2010 – 2013 is analysed. In the third part of the Thesis internal medical audit activity in the Public Institution Panevėžys Republican Hospital is evaluated at the approach of internal medical auditors and consultants. Following the analysis of the internal medical audit activity of 2010 – 2013 and the results of the qualitative research, in the final part of the Master’s Thesis conclusions and recommendations for the improvement of internal medical audit activity in the Public Institution Panevėžys Republican Hospital are presented.

This text considers a possibilities of using business valuation methods in an evaluation of the private and public health care institutions in the Czech Republic. It tries to explain the specifics associated with the functioning of health care institutions and their influence on the choice of the valuation standards, valuation methodology and the selection of the final method of valuation. The first part describes health care institutions and their operation in the health care market. Other parts deal with the possibilities of the evaluation separately for private and public health care institutions. Differences are summarized in the conclusion.

Magistro baigiamajame darbe išanalizuota ir įvertinta sveikatos priežiūros institucijoje teikiamų socialinių paslaugų kokybė, iškelta kokybės matavimo ir vertinimo problema bei pateikti siūlymai, kaip šias problemas spręsti. Pirmojoje darbo dalyje teoriniu aspektu tiriama viešųjų paslaugų vadyba, pateikiama socialinių paslaugų samprata, aptariamas jos teisinis reglamentavimas. Antrojoje dalyje nagrinėjama paslaugų kokybės vadyba, paslaugų kokybės sampratos problematika, kokybės matavimo ir vertinimo pagrindinės tendencijos bei problemos. Trečiojoje darbo dalyje pateikiama empirinių tyrimų rezultatų analizė, kuri atskleidžia sveikatos priežiūros įstaigoje teikiamų socialinių paslaugų kokybę ir šių paslaugų matavimo problematiką. / The Final Master Work analyzes and assesses the quality of social services offered in health care institution, reveals the problem of quality evaluation and assessment, and provides recommendations for solving the problems. The first part of the Final Work analyzes the management of public relations, introduces the concept of social services and discusses the legal regulation of the concept. The second part provides the research on the quality management of services, the issues in the concept of quality of services and the basic tendencies and problems in quality evaluation and assessment. The third part gives the analysis of the results of empirical surveys that reveals the quality of social services offered in health care institutions and the problem of services evaluation.

The aim of the study was to analyze quality of investigation and treatment in the specialized services – dermatological and sexually transmissible diseases outpatient department of the II Kaunas Clinical hospital and private health care institution “Medidermas”. Methods. Study population – patients with dermatological and sexually transmissible diseases. Randomly selected patients were interviewed in 2004 September-October. Totally 157 patients from state and 62 from private institution were investigated. MS Office Exel and EpiInfo 6.0 packages were used in the statistical analysis. Results. Mean age of the investigated was 42.5±1.1 yrs. One quarter of the investigated chose health care institution, recommended by familiar or friend, only 24% applied to specialized departments with referrals. The majority of respondents (85.5%) of the private institution “Medidermas” were accepted after few days of registration, 38.2% (p<0.001) of the dermatological and sexually transmissible diseases outpatient department of the II Kaunas Clinical hospital were accepted after one or two weeks. 45.2% of the investigated in the private service were registered in the interval of 10 minutes, 43.5% - 15 minutes. In the state institution only 17.8% (p 0.001) were registered during 10 minutes and half – 15 minutes. The respondents of “Medidermas” had a longer waiting time before acceptance to a medical doctor as compared to the state health care service (in 10 minutes 41.9% and 17.3%, p<0.001... [to full text]

Darbo tikslas. Ištirti pacientų požiūrį į pirminės sveikatos priežiūros įstaigose (PSPĮ) teikiamas paslaugas. Uždaviniai: 1. Ištirti privačios ir viešosios PSPĮ pacientų požiūrį į teikiamas paslaugas. 2. Palyginti privačios ir viešosios PSPĮ pacientų nuomonę apie gydytojo teikiamą informaciją susijusią su ligos diagnoze ir gydymu. 3. Palyginti privačios ir viešosios PSPĮ pacientų požiūrį į teikiamas paslaugas. Tyrimo metodika. Viešosios ir privačios pirminės sveikatos priežiūros įstaigų pacientų anoniminė anketinė apklausa, kurios metu išdalinta 800 anketų (350 privačioje ir 450 viešojoje gydymo įstaigoje). Privačioje gydymo įstaigoje atsako dažnis 92,6 proc., viešojoje – 63,1 proc. Anketiniai duomenys apdoroti ir analizuoti naudojant statistinį duomenų analizės paketą SPSS 13.0. Rezultatai. 94,4 proc. pacientų teigiamai vertina bendrosios praktikos gydytojų darbą. 30,2 proc. pacientų mano, jog šeimos gydytojo konsultacijos laukia per ilgai ir 36,5 proc. mano, jog gydytojo specialisto konsultacijos laukia per ilgai. 39,4 proc. sutinka jog laukimo eilės prie gydytojų kabinetų susidaro dėl prasto darbo organizavimo. 15,1 proc. nuomone, visada sunku gauti siuntimą pas gydytoją specialistą, kartais sunku - 43,9 proc. Viešojoje (68,7 proc.) ir privačioje (64,0 proc.) įstaigoje teigia, jog šeimos gydytojas visada tariasi dėl gydymo galimybių pasirinkimo, tačiau viešosios (6,7 proc.) o privačios (0,3 proc.) įstaigos pacientų teigia, jog gydytojas niekada nesitaria. 53,8 proc... [toliau žr. visą tekstą] / Aim of the work. To examine patients attitude towards services provided in primary health care institutions (PHCI). Objectives: 4. To investigate patients attitude towards services provided in primary health care institutions. 5. To compare patients of private and public primary health care institutions opinion about the information on their diagnosis and cure that doctors provide. 6. To make a comparison of the private and public primary health care institutions to provided services. Research methodology. It was done an anonymous questionnaire survey of public and private primary health care institutions patients, distributed 800 of questionnaires ( 350 in private and 450 in public primary health care institutions). In private health care institution 92,6% of answers were received, in public institution - 63,1%. Data of the questionnaire were processed and analysed using statistical data analysis packet SPSS 13.0. Results. 94,4% of patients positively evaluated the work of family doctors. 30,2% of patients think, that they have to wait too long for family doctors consultations, 36,5% think, that they wait too long for the consultation of specialist. 39,4% agree that they have to wait long because of bad work planning. 15,1% of respondents think that, it is always difficult to get a committal to the specialists, sometimes difficult - 43,9%. 68,7% of public and 64,0% of private institutions respondents says that, family doctor always consults about choosing a cure, but 6... [to full text]

Žmogaus sveikata – multidimensinis reiškinys, tai – tarpusavyje susijusių veiksnių: fizinės, emocinės/dvasinės sveikatos, socialinės gerovės, visuma. Todėl integruotos sveikatos priežiūros pagrindas yra visuminė (holistinė) idėja, reikalaujanti reiškinį suvokti kaip tam tikrą visumą, netolygią jos elementų sumai. Siekiant visapusiškai padėti sergančiam žmogui reikia ne tik medicininės srities specialistų pagalbos, tačiau reikalinga ir svarbi tampa sveikatos priežiūros įstaigoje dirbančio kompetentingo socialinio darbuotojo veikla. Socialinis darbas sveikatos priežiūroje yra pakankamai nauja socialinio darbo sritis Lietuvoje, dėl to susiduriama su: informacijos apie socialinio darbo profesiją, socialinio darbuotojo veiklą ir jo funkcijas, problema. Pastebėta, kad socialinio darbo problematika sveikatos priežiūros įstaigose aktuali, todėl reikalinga sistemingų ir išsamių tyrimų šioje srityje. Lietuvos sveikatos priežiūros įstaigose socialinio darbo profesija nuvertinama, o socialinio darbo specialistai susiduria su įvairiais sunkumai ir problemomis dirbdami medikų apsuptyje. Nors socialinių darbuotojų padėtis sveikatos priežiūros srityje nėra palanki, tačiau profesija reikalinga dėl sveikatos ir socialinių klausimų susietumo bei naujo požiūrio, kad sveikatos priežiūros paslaugos turi būti teikiamos kartu su socialinėmis paslaugomis. Socialinis darbuotojas, remdamasis savo profesine kompetencija, sveikatos priežiūros įstaigose, teikia socialines paslaugas, padeda asmenims... [toliau žr. visą tekstą] / Health is a multidimensional concept. It is a complex combination of a person's physical, mental, emotional and social health factors. Therefore an integrated health care is based on the total (holistic) concept and requires understanding the phenomenon into account and seen as a whole. In order to fully help to sick person need not only medical professionals, necessary and important are qualified social worker’s activities working in health care institutions. Social work in health care is quite new field of social work in Lithuania, therefore faced with: information about the social work profession, social worker’s activities and social worker’s functions, problems. It was noticed that social work issues is relevant in health care institutions and requires systematic and comprehensive research in this social work area. Social work profession is downplayed in health care institutions in Lithuania and social work professionals are facing to various difficulties and problems of working in the medical teams. Although the social worker’s status in the health care sector is not favorable, but the social work profession is necessary for the relationship between health and social issues as well as the new approached that health care services must be providing integrated with social services. In health care institutions, social worker on the basis of the professional competence, provides social services, he helps people with health problems to integrate into society and encourages... [to full text]