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ARMEN HAYRAPETYAN, MD, PHD
NATIONAL TB CONTROL OFFICE
DIRECTOR
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TB OUT PATIENT
FACILITIES
21 TB OUT
PATIENT
FACILITIES IN
YEREVAN (CAPITAL)
51 TB OUT
PATIENT
FACILITIES
IN REGIONS
1. REPUBLICAN
TB DISPANSER
(RTBD)
2. YEREVAN
CITY TB
DISPANSER
(CTBD)
2 TB IN PATIENT UNITS (HOSPITAL
FOR DETAINEES AND IN-PATIENT
DEPARTMENT IN PRETRIAL DETENTION
FACILITIES) IN PENITENTIAL SYSTEM
MINISTRY OF HEALTH/NATIONAL TB PROGRAM
TB IN PATIENT
FACILITIES
7 IN-PATIENT
TB
DEPARTMENTS
IN REGIONAL
GENERAL
HOSPITALS
NATIONAL
REFERENCE
LABORATORY
29 MICROSCOPY
LABORATORIES
TB LABORATORIES
Reduce high level of hospitalization rate of TB patients (95%),
Improve TB hospital care quality,
Enhance outpatient TB services performance:
Increase TB case detection rate,
Increase TB treatment success rate,
Improve social support activities of TB patients
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State financing of the tuberculosis (TB) treatment and
care services in the Republic of Armenia (RA) is done
through the National Health Agency (NHA) of the MOH of
RA.
Services receiving financing are the following:
Out-patient (ambulatory) services
In-patient services
Sanatorium services
1. In-patient service financing: Base for the financing is the number of bed/days (load)
2. Out-patient service financing: In case of out-patient care financing done on per capita basis
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IN-PATIENT
AND
OUT-PATIENT
HEALTH CARE
CENTRES
HEALTH
STATE
AGENCY
REPORT
FINANCING
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0% 20% 40% 60% 80% 100%
Treatmentprocess
Diagnosis
Intensivephase
treatment
Expenses
70%
35%
5%
17%
30%
65%
95%
83%
In-patient Ambulatory
• Total state budget for TB service is about 4 million USD
• About 83% (3,4 millio USD)of them for in-
patient service
• Abour 17% (0,6 million USD) of them for out-patient service
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• Food packages for all TB patients
• Hygiene packages for all TB patients
• Training sessions on TB for all TB patients
• Transportation cost for all TB patients
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• Provide incentives for the primary health care (PHC) doctors based on the performance: Number of confirmed TB cases among suspects referred to the TB doctor from PHC
• Provide incentives for the TB doctors based on the performance:
Number of successfully treated patients
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• Whithin the “TB medical care services” program
plan separate financing mechanism for the TB
departments and dispensaries which include
provision of:
• Fixed costs of hospital maintenance
• Variable costs by the number of TB cases
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Year
Cost
Fixed Variable Total
% 76 % 24 % 100 %
• Decrease number of TB hospitalizations
• Optimization of the in-patient TB departments
(number of beds)
• Strengthen of the Primary Health Care service
• Early detection of the TB cases
• Early diagnosis of the TB cases
• Improved treatment outcomes
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Improved TB performance indicators for both, in-patient and out-patient TB services:
TB detection rate
TB treatment rate,
Quality improvement of TB in-patient and out-patient TB services,
Raising of satisfaction of patients and health care providers
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