Academic journal article Journal of Community Positive Practices

Perceptions of a Sample of Physicians from Bucharest upon Romanian Health Policy 1

Academic journal article Journal of Community Positive Practices

Perceptions of a Sample of Physicians from Bucharest upon Romanian Health Policy 1

Article excerpt

Introduction

The medical system in Romania has gone through some changes over the last 25 years, but it has not improved the quality of services at the level expected by public and by medical personnel, taking as reference the European average performance. The average life expectancy remains among the lowest in the region (74.4 years versus 80.3 EU27 average) and healthy life expectancy at birth (57.9 years, Romania 2013, compared to 61,5 years the average UE28) experienced a slight decline from 2007 to 2013 in Romania, both women and men (62.9 years in 2008 to 57.9 in 2013) (EUROSTAT, 2015)

Rates of morbidity and mortality are in Romania, a combination of specific indicators of developed countries (mortality from cardio-vascular diseases, the increase in cancer morbidity rates) with specific indicators of developing countries (the rate of infectious diseases, the increased rate of TB and rate of sexually transmitted diseases). Although most indicators have improved all along the period of 25 years after the revolution, a number of indicators still remains very problematic, far behind the EU average: the highest infant mortality in the EU (9 at 1,000 live births compared to 3.8 EU27 average in 2012) and the highest incidence of TB in EU (87 per 100,000 population in 2013, 10 times higher than some Western EU countries). (EUROSTAT, 2015)

The main cause of death in Romania are cardiovascular system diseases. In the West Europe, the trend is to reduce this rate; in Romania, it is growing. Deaths attributable to malignancy are below the EU average, but one should note avoidable deaths: the highest rate of death from cervical cancer in the EU, reflecting the inadequacy of the system to the needs of the population. Infant and maternal mortality indicators are also a strong correlation with the performance of the health system.

Also, in developed countries, health resources began to demand considerable effort. Life expectancy has increased in the European Union and the share of population aging (the main consumer of services in total), also modern drugs/interventions are costly. All these are important fiscal pressures. Although the Romanian state's financial efforts have increased over the last 10 years, in absolute numbers and percentage, the system deficiencies persist and, in the European context, Romanian health finance remains low. Romania continues to be one of the last places in the EU in terms of health resources. (4.36% of GDP government allocation, including social security funds, that is half of what countries like Germany, France, Belgium and the Netherlands allocate). The allocation of health finance should reach a minimum of 6% of GDP. (EUROSTAT, 2015)

In spite of statistical indicators, interviewed physician show that Romanian population's state of health is not overall known. A national screening was done couple of years ago, with the aim of knowing population's health state. Unfortunately, only a part of population, including a large part of the old age generations have responded, as the screening was not compulsory.

"Before 1990, there were mandatory checks, even if it was a reduced screening, but they did some research and population was known. Now, I organized a workshop for gastric cancer, where I invited some teachers from Japan. We are in an embarrassing situation because, in spite all the relationships we have in Ministry of Health, the Health Insurance Fund, I cannot say which is the incidence of gastric cancer in Romania. There is nothing to tell us what is happening in Romania with this rate. Basically, we do not even know what is happening in our health system."

"We do not know the real situation of the health of the population. We are influenced by what we saw on TV that everything was dramatic. Perhaps the situation is not so dramatic or it is even worse than we think. Media campaigns have always media interest on their back. There are not aimed at sustaining the health of the population. …

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