Romanian Healthcare System

Center for Health Policy and Public HealthBabes-Bolyai University Cluj

Romania

Master Programs in Public Health and Social Care 511303- TEMPUS-1-2010-1-UK-TEMPUS-JPCR

Yerevan, Armenia - February 2011

Source: Health Systems in Transition; vol. 10; no. 3; 2008. ROMANIA. Health System Review; p.24

Organizational structureRomanian healthcare system

Minister of Health National Institute of Public Health

County Authorities of Public Health

Regional institutes of public health

National Colleges of

Health Professionals

County Councils

Health services – inpatient & outpatientHospitals, physician practices, polyclinics

County Colleges of

Health Professionals

Insured / Patients

County Health Insurance Houses

National Health Insurance House

Organizational structureRomanian healthcare system

FinancingRomanian healthcare system

Source: Health Systems in Transition; vol. 10; no. 3; 2008. ROMANIA. Health System Review; p.40

Education systemEducation of health professionals

Public medical universities - 11

Private universities - 2

Physicians/dentists MD – 6 yearsResidency – 3-7 years

Pharmacists 5 yearsNurses/midwives 4 years

Professional development

Academic Master – 2 yearsProfessional Master – 1 yearPhD – 1 year

Regulation and service providersHealthcare Primary care Family doctors

Secondary carePublic

Hospitals, oupatient departments, centers for diagnosis and treatment, office-based specialists

Tertiary carePublic

Teaching hospitals, specialized hospitals

Private sector Private fundingContracts with the National Health Insurance Fund

Legal framework for healthcare providers

Number of hospital beds Opening or closing of hospitals

Ministry of Health

Main health care reformsSource

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Recent reforms - 2010

Introduction of co-payments Excluded: people under the age of 18 (or 26 if

they are students); retired people (if their pension is below 700 RON); people without any income

Regulations regarding the hospital managers’ selection process

National strategy for hospital rationalization Administrative organization / Financing / Hospital

management / Human resources / Informal payments and corruption / Malpraxis / Quality assurance

Coverage with health professionals

1.4 doctors/1000 - Romania

3.2 doctors/1000 - EU average*

2,779 doctors solicited in 2010 certificates of good-standing, in order to practice outside Romania**

*WHO Regional Office for Europe(2004)**Romanian College of Physicians (January 2011)

Migration of resident and specialist doctors (Germany, France and UK)

Low motivation - low level of salaries;Lack of long-term strategy for human resources recruitment

Challenges

Conclusions

The Romanian healthcare system is undergoing a series of profound changes and reforms

Human resources in any system should be of a particular concern