Public Health

Prioritisation of investments in health infrastructure according to the patient’s actual needs

Current situation:

• Now, Romania allocates only 4% of GDP to the health sector (unlike the EU average of 7%);
• In Romania, there are 2.72 doctors / 1000 inhabitants (under the EU average of about 3). Although the average is higher in Bucharest and other large cities, there are regions where the average is below 1 doctor / 1000 inhabitants;
• Despite the average performance indicators, Romania has the penultimate average life expectancy (75 years) in the EU due to an inefficient distribution of infrastructure resources;
• 30% of the hospital area is currently under seismic risk 1 or 2; 
• At national level, there are 103,000 hospital beds and approximately 4 million cases treated annually;
• In Romania, each physician (with support staff) is responsible for about 3 patients, unlike the UK (1 physician / patient), Austria (1.5 physician / patient), Bulgaria (1.7 physician / patient). If we take into account Bucharest, the number can even reach 5 patients / physician;
• Hospitals in Romania treat 1.4 million more patients than they would be capable of in optimal parameters.

Proposed measures:

1. Increasing  the level of funding to at least 6% of GDP in 2-4 years through gradual annual growth.
2. Placing the patient at the heart of the Romanian health system by correlating the investment programs with the actual need of the patient.
3. Improving the capabilities of major medical centers to treat poly-trauma.
4. Opening and / or strengthening of 243 primary health centers – most Romanians are treated in hospitals, although it involves higher costs and an overload of the specialized human resource.
   • Hospitals in Romania treat 1.4 million more patients than they would be capable of in optimal parameters. Approximately 1.6 million patients could be treated in primary health centers. The current system is ineffective and inefficient, based on the use of the hospital as the standard healthcare infrastructure/service. In modern EU healthcare systems, primary health centers replace hospitals as the standard healthcare facility.
5. De-politicization of health infrastructure management

Setting in place a professional management teams in hospitals, decentralization of health management and clear delegation of responsibility for investment decisions, so that hospital directors (403 hospitals in Romania) can make the right decisions about staff and expenses without being politically threatened.

Restructuring the compensation and remuneration system of all medical staff by setting up result-based payment  mechanisms that focus on the quality of the medical act instead of fixed amounts (e.g. wages) that do not take into account the quantity and quality of the performed medical services.

Team work always gets the best results. Above you have read the summary of the problems and solutions we have identified. I look forward to your opinions and recommendations on “Health“.

Also, don’t forget that great things are not made by a single individual! Send any questions or comments you may have.

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