Since September, according to the announcement of the Minister of Health, Alexandru Rogobete, public hospitals must display on the site the number of patients admitted, the number of available places and other basic data. The measure is presented as a step towards opening the system to citizens, but experts warn: without a unique, standardized site, the initiative risks remaining a bureaucratic check -up.
Hospitals, forced to publish on their website a series of Freepik photo transparency indicators
“Starting in September, hospitals will be forced to publish on their site a series of indicators for transparency. Namely the number of patients admitted, the degree of bedding of the previous month, the percentage of the contract with the National Health Insurance House and the number of patients transferred to other hospitals.”said the Minister of Health, Alexandru Rogobete, on a work visit to Deva.
It is, on paper, an important step. Patients could find out, theoretically, which hospitals are more crowded and where most transfers are made. The press and NGOs would receive an additional monitoring tool. However, the question is whether hospitals are truly prepared to implement this requirement.
The idea, over 15 years old
The assumed publication of statistics is not an invention of the current mandate, said the president of the National Association for Patient Protection (ANPP), Vasile Barbu, for Adevărul.
“The idea of publishing statistical data, regarding the activity of each medical unit is older, even from 2010ogiven with the establishment of the health alliance in Romaniawhich
It was my idea. All my idea was to publish on the websites of hospitals statistical data related to the hospital budgetary market, the direct costs for each patient- the average of the direct costs, the public procurement, the competitions for occupying the positions, many other specific data related to the contact details for the hospital sections ”said Vasile Barbu, ANPP president.
In fact, Romania has a long history of transparency initiatives, but most have been blocked either due to lack of political will, due to lack of funding or due to the technical problems.
Hospitals and the problem of outdated sites
Technology can be a great obstacle, if we talk about the implementation of data on the site of each hospital, starting next month. The ANP president comes with a clear warning:
“It is not possible for all hospitals to do this. There are hospitals that do not even pay maintenance on the site. Take some provincial hospitals and ask them when they have last purchased a maintenance for the site. It is possible for some hospitals to have a maintenance Time and not all hospitals have the opportunity, “Barbu told Adevărul.
More serious, many hospitals do not even have basic information on the site, such as the list of sections or the names of available doctors.
“Peak, precisely the hospitals with problems will not be able to publish this,” he pointed out.
Solution: a unique site
Thus, he argues that the central idea is not to divide transparency on hundreds of local sites, but to create a unique, coherent system, accessible to the public. In this sense, Barbu gives the example of everyday situations, which he himself is hit.
“I almost daily access up to 5 hospitals. It is very difficult for me to get some contact details, they often have outdated emails, or they are yahoo, gmail which is not correct. It proves that hospitals do not have secure data and any hacker can easily enter. This is why it is important to make a site, through an order of minister to set the minimum site of the site, with all functions. The Ministry of Health to make a regulation, through a centralized auction, a standard type of site. The data are the same, the requirements are the same. Even private hospitals can buy this license ”, said ANP president.
Moreover, the leader of ANPP says that he wanted, last few years, to initiate a European project in this regard, but has not found a financing line until today.
“This is a project with European funding, to make this site. After being completed to be made in partnership with the Ministry of Health, the Association of Public Hospitals ”,
added Vasile Barbu.
Impossibility of patient transfers: Symptom of lack of communication
Such a system could save lives. Especially since the problem is seen and about the transfers between hospitals. These are problematic, especially during the night, sometimes and during the day. Sometimes, impossible to achieve. Among the main causes are the lack of communication and the lack of centralized data.
“A medical map could also be placed on the website of each hospital. Thus, either day or night, the patient can be saved by directly transfer from home, not to be taken over by a medical unit that has no competence on the case. There are many aspects related to communication: both communication between the hospital and the patient, the hospital and the medical, but also the hospital. In Bucharest or in Iasi or Cluj, with another level of competence, you will see that it is not possible.points out the ANP leader.
In conclusion: “This transparency system would no longer allow some doctors or heads of section to refuse the patients,” he added.
Vasile Barbu came including a recent example of immediate topicality:
“This morning (Monday, August 25 – no) from Giurgiu a patient had to be transferred to Bucharest. Everyone was looking for the doctor, besides the fact that he had no contact details, the phone number, at the central hospital he was waiting for him. It should not be allowed to use the network from the hospital secretariat for this. Operational communication chains must be made that allow direct access for making decisions in emergency medical cases or in which early approaches are required ”said ANPP president.
A unique site, with standardized information, could eliminate these blockages.
Who checks the data?
To this question, the president of the National Association for Patient Protection has vehemently answered: “He has no one.”
Therefore, even if the hospitals manage to publish the data, however, the question of their truthfulness is raised. In Barbu’s vision, the role of verification should belong to the institutions that already have control duties: CNAS, the Ministry of Health and DSP, but through a standardized clinical audit mechanism.
“We have another proposal, which was agreed by CNAS, at a meeting of a month ago, we proposed to regulate the clinical audit. It allows either the National House, the Ministry, the DSP or the courts, the control of the medical act,” said Barbu.
He also gave a concrete example: in the case of a trivial operation, such as appendicitis, hospitals sometimes report unjustifiably high costs, and the money at the Insurance House ends quickly. The problem is not the lack of funds, but the fact that no one verifies whether the reported medical services correspond to reality.
“That is why the budget of national health houses is exhausted in the first six months or even less. Everyone spends as much as he wants. No one says: How much do you need for an appendicitis operation? I do not say to make the standard cost, on the contrary, we make real costs, but there is a margin of expenses. You cannot spend 100,000 lei only for the appendicitis operation ”concludes Barbu.
Thus, the obligation for hospitals to publish data from September 1 can be viewed as a step forward, but without digital infrastructure the measure risks remaining only on paper.
