Using Structural Funds to improve health care in Slovakia

Comparison of current and new programming period

Ministry of Health of the Slovak Republic

Programming period 2007 - 2013

Strategic planning Analysis

high mortality and morbidity decreased life standard, low productivity obsolete infrastructure and medical equipment of healthcare providers low quality, effectiveness, accessibility and security of healthcare

Programming period 2007 - 2013

Strategic planning Key words

Group 5 diseases cardiovascular diseases, onocological diseases, external causes of diseases and deaths, respiratory system diseases, digestive system diseases Complexity support economically sustainable complex changes of the health care providers focused on the increasing of their productivity in compliance with the future demand for services (complex restructuring program)

Programming period 2007 - 2013

Strategic planning Strategy

Investments into hospital and outpatient infrastructure focusing on the treatment of group 5 diseases to improve quality, accessibility and efficiency of provided health care Priority axis 1 Modernization of hospitals (80% of total budget) Priority axis 2 Modernization of policlinics and health care centres (20% of total budget)

Programming period 2007 - 2013 Financial indicators (September 2013) contacting: 98% disbursement: 80%
Priority Beneficiary axis PO1 Specialized hospital No. of projects 11 Average size of project (EUR) 2 500 000

PO1
PO2 Total

General hospital
Outpatient facility

15
38 64

13 620 000
1 211 000 4 375 000

Programming period 2007 2013 Projects examples

New premises Emergency and Intensive Care Unit in Faculty hospital in ilina

New equipment Catheterization Lab in Kardiocentrum Nitra

Infrastructure modernization Extension of Children's Faculty Hospital in Bansk Bystrica

Programming period 2007 - 2013 Strengths:

separate OP coordination and implementation by the Ministry of Health achieved results financial indicators achieved thematic results: quality (59%) new methods and procedures, enhancing the quality of existing methods and environment, decrease of rehospitalization efficiency (23%) increasing of productivity, shortening of hospitalization, energy savings, digitizing accessibility (18%) access to new type of methods, shortening of waiting time, barrier free facilities unique opportunity for substantial qualitative improvement of health care infrastructure

Programming period 2007 - 2013

Weaknesses:

absence of overall national strategic framework in the field of health diversity of supported areas immeasurable impact of interventions absence of relevant measurable result indicators unavailable source of data for quantitative impact evaluations mono-fund approach

Programming period 2014 - 2020

Strategic planning analysis/challenges

demography change ageing population amount of public sources in health care will be stable or will slightly decrease (impact of ageing population and economic crisis) number of staff in health care will be decreasing

Specific problems of Slovakia: very low efficiency of Slovak health care system expected healthy life years at birth in Slovakia 52.4 years (OECD average 62 years) obsolete hospital buildings (average age 42 years) general practitioners are not acting as gate-keepers average age of general practitioners (GPs) - 54 years

Programming period 2014 - 2020

Strategic planning national priorities (EAC)

Outpatient care

transfer of health care services from acute hospitals to community health centres reinforce the gatekeeping role of GPs in primary contact network (general out-patient care) overall reduction of acute hospitals substantial increase in the productivity of health care personnel shorter average length of stay in acute hospitals innovative modernization of health care infrastructure non medical prevention increase the health status of marginalized and excluded communities

Inpatient care

Public health

Programming period 2014 - 2020

Implementation strategy scheme

ERDF

Sustainable modern infrastructure

ESF

Efficiency Accessibility

Transformation Integration New processes

Human resources

Programming period 2014 - 2020

Main priorities for SIF funding

ERDF

New network of primary health care centres

ESF

GPs acting as gate keepers

Transformation of GP role

New standardized clinical and prevention guidelines

Integration of GP network

Resident programmes attract young people to crucial specializations like GPs

Comparisons and conclusions

PO 2007 2013

PO 2014 2020

Mono-fund approach Lack of strategic approach and concentration Programming before crisis

Renewal of health infrastructure

Replacement for national sources

Multi-fund approach Ex ante conditionality, result oriented approach Impacts of crisis fiscal consolidation sustainability efficiency Transformative and reform oriented infrastructure investments EU added value of SIF

Well timing of SG2 work Usefulness and importance of toolbox

Ministry of Health of the Slovak Republic

www.opz.health-sf.sk info.opz@health.gov.sk