Zeeland Denmark EU Office Brussels, 11th May 2009

Presentazione sul tema: "Zeeland Denmark EU Office Brussels, 11th May 2009"— Transcript della presentazione:

1 Zeeland Denmark EU Office Brussels, 11th May 2009
Veneto Health System Zeeland Denmark EU Office Brussels, 11th May 2009 Daniela Negri

2 Summary Part 1 Part 2 Part 3 National and Regional Health System
Regional Health Care Resources Part 2 Objective and Priorities Waiting List Part 3 Partnership and networks EU Projects Contacts 11th May 2009

3 Part 1 National and Regional Health Systems
Regional Health Care Resources 11th May 2009

4 Veneto Region km 2 4.8 million inhabitants 11th May 2009

5 Health devolution: From 2001 new competences for the regions
Italian Constitution: New Art.117: All domains concerning human health pertain to the legislative function of the Regions. Regions are responsible to plan and provide health and social services. 11th May 2009

6 Italian Health Care System
Universal coverage, free of charge; Funded through general taxation; 3 level:- National: General objectives & fundamental principles LEA - Essential levels of care provision Regulatory function for drugs & medical equipment - Regional: Management & organisation: target orientation, delegating management to Local Health Authorities (LHA) and structures; Coordination and control Financially accountable Legislative & administrative functions Planning - Local: Management &delivery 11th May 2009

7 Veneto Region Social and Health Care System Organization Chart
11th May 2009

8 Veneto Health Care Model
Multi-tiered structure in the territory Structural integration between local community and hospital Integration between social and health care Delegating management to local health authorities (LHA) Fostering coordination between LHA, NGOs, public authorities 11th May 2009

9 Veneto Region Health System: Numbers and Figures
21 territorial LHAs (managing 60 hospitals) 2 public hospital trusts 1076 specialist health care service providers 1307 pharmacies 3600 general practicioners 250 residential home for the elderly hospital beds in the public system are 19,429 (85.85% of the regional total) and 3,470 private hospital beds (15,15%) 11th May 2009

10 The Veneto Region is divided into 21 Local Health Authorities (LHAs)
The Veneto Region is divided into 21 Local Health Units or ULSS 11th May 2009

11 Financing - I Regional Health System  Based on general taxation.
The Government together with the Regions negotiates annual quota for funding the regional systems. LHA global budget - weighted capitation mechanism - adjusted according to the historical spending - additional compensation is given for cross-boundary inter-regional flows; Hospital providers: fees for services ( DRG) ; GPs capitation. 11th May 2009

12 Financing - II Percentage of total expenditure on health
according to source of revenue (2004) 11th May 2009

13 Financing - III 11th May 2009 1988-2004 (billion € at 2000 GDP prices)
Trends in health care expenditure in Italy (billion € at 2000 GDP prices) Trends in health care expenditure in Italy, Indicators 1988 1990 1995 2000 2003 2004 Total health expenditure in per capita US$ PPP 1 195 1 391 1 535 2 049 2 266 2 424 Total health expenditure as a percentage of GDP 7.7 7.9 7.3 8.1 8.4 8.7 Public expenditure on health as a percentage of total expenditure 77.6 79.1 71.9 72.0 73.7 75.1 Private expenditure on health as a percentage of total expenditure 22.4 20.9 28.1 26.5 24.9 23.6 11th May 2009

14 Regional Investment in Health & Social Services 2008
Regional budget allocation for Healthcare: € 7.2 Billion Regional investment allocated to the Social Sector: For financing other programmes: home care for the elderly; support to families with chronically-ill dependent; telehelp for caregivers; services for disabled people For non self-sufficient, mainly elderly citizens and other vulnerable population groups The total budget for public health and health care in the Region was 6.7 Billion euro in the year Out of this, 520 Million was allocated to the Social Sector, to address the needs of more vulnerable groups, examples of whom are shown here. €820 M To provide services to drug addicts 11th May 2009

15 Veneto Region – Health Expenditure
11th May 2009

16 Part 2 Objective and Priorities Waiting List 11th May 2009

17 Health and Social Affairs Plan 2007-2009 (1)
Strategic Objectives: Better Implementation of Essential Level of Care Provision Reducing Waiting Lists Reduction of costs maintaining high quality Increasing Prevention and Health Promotion: Healthy life styles promotion Increasing prevention Promotion to a correct use of medical drugs Promotion of policy addressed to family, adolescent, infants and young people Health and integration of immigrant people Increasing Quality 11th May 2009

18 Health and Social Affairs Plan 2007-2009 (2)
Renewing Health Care System Better integration of providers and hospitals Interoperability among health systems, including emergencies units Better collaboration between universities and health providers for training Improving utilization of smart-cards Improving Research and Innovation: Increase biomedical and health research; Increasing use of technology (HTA, diagnosis, …) Use of innovative managerial and organization model Citizenship Participation: Freedom in choosing health care providers Involvement of Third Sector Better communication 11th May 2009

19 Economic Pressures on Veneto Regional Health and Social System
Impact of Technologies: Rising costs due to technological innovation Demographic and Social Changes: Ageing population Patient mobility: tourists, immigrants, long term residents Lack of health professional (mainly paediatricians and nurses) Waiting Lists 11th May 2009

20 Tackling a challenge: Reducing waiting lists…
National Plan for Reduction of Waiting Lists Oblige Regional Authorities to: Define a Regional Work Plan to reduce waiting lists Define the maximum number of waiting days for each disease category Define financial consequences for unfulfilling Regional Authorities Regional Law DGRV 300/2007 and “Intramoenia” experience Local Health Authorities Implementation 11th May 2009

21 Reducing Waiting Lists… (2)
Regional Law DGRV 300/2007 4 main objectives: Definition on each prescription the specialistic visit category and maximum of waiting days allowed per category Definition of 2007 targets Implementation of a monitoring system Evaluation of Local Health Authority Directors on the basis of the Waiting List Plan’s results 11th May 2009

22 Reducing Waiting Lists… (3)
DGRV 300/ Objective 1 :Definition on each prescription the specialistic visit category and maximum waiting days allowed per category Hospital Admission Category Description Maximum Waiting days A disease tending to become emergency 30 days B disease with intense pain or serious disability, not tending to become emergency 60 days C disease with slight pain, without relevant disability, not tending to become serious 180 days D disease without pain and disability 12 months 11th May 2009

23 Reducing Waiting Lists… (4)
DGRV 300/ Objective 1 :Definition on each prescription the specialistic visit category and maximum waiting days allowed per category Examination Category Category Description Service Maximum Waiting days A disease tending to become emergency General examination 10 days Specialistic examination B disease with intense pain or serious disability, not tending to become emergency 30 days 60 days C disease with slight pain, without relevant disability, not tending to become serious 180 days D disease without pain and disability 11th May 2009

24 Reducing Waiting Lists… (5)
DGRV 300/ Objective 2: Definition of 2007 targets Category 31/12/2007 31/12/2008 Physician Office service A 80% 90% B 70% C 100% D Hospital Admission 50% Oncology 11th May 2009

25 Reducing Waiting Lists… (6)
“It’s time to care” Advertising campaign to inform citizens on their rights on waiting time for care 11th May 2009

26 Reducing Waiting Lists… (7)
Intramoenia experience: Possibility for patients to be cared in a public structure in a private visit by a private specialistic physician; Public Service Fee < Intramoenia Fee > Private Fee; Guarantees citizens’ freedom of choice; Contributes to reduce waiting lists 11th May 2009

27 Part 3 Partnership and networks EU Projects Contacts 11th May 2009

28 Representative Offices of the Veneto Region
Venice 11th May 2009

29 International Health and Social Affair Office activities in Venice
Development of joint programmes with the WHO Health care emergency programmes Interregional coordination with the Italian Ministry of Health, the Foreign Affairs Ministry and the Italian Red Cross Organisation of study visits of regional delegations Organisation of workshops Twinning initiatives with the regions of candidate member states 11th May 2009

30 Brussels Office Regional participation in EU health care policy development Monitoring of EU public health activities and initiatives EU funded projects Training and information activities on EU topics 11th May 2009

31 Participation in international networks
Regions for Health Network Alpe-Adria Working Community European Observatory on Health Systems and Policies ERRIN EUREGHA 11th May 2009

32 WHO REGIONS FOR HEALTH NETWORK
Flemish Community Varna Northern Bohemia, Northern Moravia Lower Saxony, North Rhine- Westphalia Bács Kiskun, Györ Monson Sopron Szabolcs-Szatmár Northern Region Emilia-Romagna, Veneto, Sicily Kaunas Rogaland Silesia Madeira Vologda Catalonia, Extramadura, Valencia Västra Götaland, Östergötland Ticino North West England, Wales Belgium Bulgaria Czech Rep Germany Hungary Israel Italy Lithuania Norway Poland Portugal Russia Spain Sweden Switzerland United Kingdom Present the Regions for Health Network one of WHO’s policy networks The background Who we are Our focus and the context of the work Specific activities of the Network

33 Alpe Adria Working Community
11th May 2009

34 The European Observatory on Health Systems and Policies
Partnership: International Organisation: the WHO Regional Office for Europe, the European Investment Bank, the Open Society Institute, the World Bank, National Governments: Belgium, Finland, Greece, Norway, Spain and Sweden, Regional Government: Veneto Region Research Institute: the London School of Economics and Political Science (LSE), the London School of Hygiene & Tropical Medicine (LSHTM), CRP-Santé Luxembourg Aim: support and promote evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health care systems in Europe. 11th May 2009

35 ERRIN Collect and give pre-information on FP7, providing ERRIN network with a technical background in FP7; Discuss and circulate methods, tools and good experiences on how regions tend to identify and develop regional development strategies; Develop proposals to open consultations; Networking. 11th May 2009

36 EUREGHA Aims to: Share information and experiences;
Forum for EU institutions and local / regional (health) authorities; Raise awareness of local / regional dimension and enhance local / regional influence on EU health initiatives; Provide expert knowledge and added value to EU institutions; Cooperate with other health networks and NGOs. 11th May 2009

37 European Health Projects managed by Veneto Region
20 running project 2 in negotiation phase (Call PH 2008) 2 in evaluation (Call FP7 2008) 11th May 2009

38 European Health Projects The Budget
Progetti in gestione Total Budget in € Cofinanc. CE To RV in € Cofinanc. RV €EC/ Budget Project RGV Health 13 € € € 38% Social Affairs 6 € € € 47% € of contribution in kind 11th May 2009

39 EU Projects - Health Titolo Oggetto Leader Ref. RGV Budget totale in €
Titolo Oggetto Programma Leader Ref. RGV Budget totale in € Cofinanz. CE alla RV in € Cofinanz RV in € 1 DETERMINE Costituire un consorzio europeo per l’azione sul controllo dei determinanti socio-economici della salute Salute Pubblica Call 2006 Istituto nazionale di salute pubblica della Repubblica Ceca SRSSI 8.476 12.000 2 SIALON Lotta all'HIV attraverso un sondaggio tramite utilizzo di kit sperimentali Salute Pubblica 2007 Regione Veneto CRRPS - ULSS 20 Verona 3 CHI-CY-TOBACCO Costruire una rete di partner europei che collaboreranno insieme per affrontare le questioni legate al controllo del tabagismo. Liverpool Primary Care Trust (UK) Azienda USL 19 Adria, Finessi 28.473 63.890 11th May 2009

40 EU Projects - Health HEALTH OPTIMUM II “HEALTHY REGIONS NETC@RDS
Titolo Oggetto Programma Leader Ref. RGV Budget totale in € Cofinanz. CE alla RV in € Cofinanz RV in € 4 HEALTH OPTIMUM II Definire uno standard organizzativo/funzionaleper l’erogazione di prestazioni sanitarie a distanza e sviluppare delle applicazioni di telemedicina eTen – call 2006 Regione Veneto USSL 9 – Treviso Ufficio Bruxelles: Ronfini e Motta 5 “HEALTHY REGIONS Promuovere investimenti pubblici in campo sanitario nelle regioni attraverso una migliore identificazione, governance e uso strategico delle competenze sanitarie regionali. Salute Pubblica Call 2006 South Denmark European Office CRRPS* - USSL 20 Verona 72.062,99 67.268 6 Estensione della versione sperimentale della Tessera elettronica Europea Assicurazione Malattie Sesam Vitale EIG (Francia) USSL 13 Dolo Mirano 11th May 2009

41 EU Projects - Health Titolo Oggetto Programma Leader Ref RGV
Titolo Oggetto Programma Leader Ref RGV Budget totale in € Cofinanz. CE alla RV in € Cofinanz RV in € 7 TEN 4 HEALTH Testare un servizio di interoperabilità delle carte elettroniche della salute eTen – call 2006 AOK Rheinland Hamburg USSL 10 Veneto Orientale e ULSS 13 Dolo Mirano 18.522 18.523 8 SEID Produrre un catalogo trasnazionale delle possibilità di intervento su prevenzione, cura, terapia e l’inclusione sociale tra i giovani per Salute Pubblica Call 2006 FICT Federazione Italiana Comunità Terapeutiche Roma Ufficio prevenzione delle Devianze 34.500 36.714 9 VENICE Armonizzare i dati riguardanti le infezioni nosocomiali e la resistenza agli antibiotici in Europa Salute Pubblica 2004 Istituto Superiore di Sanità (Italia) 51.924 60.200 11th May 2009

42 Eu Projects - Health EUnetHTA Euregio II INFORM PROMETHEUS Titolo
Titolo Oggetto Progr. Leader REF RGV Tot. Budget Cof CE a RGV Cof RGV 10 EUnetHTA Rete europea per la valutazione dell’impatto delle tecnologie sulla salute Sanità Pubblica 2005 DACETHA Dir.Piani Programmi Socio-Sanitari 17.490 25.681 Euregio II Sviluppo di strategie per l'offerta di servizi sanitari trasfrontalieri Sanità Pubblica 2006 North Rhine Westfalia 11 INFORM Lotta all'obesità nei bambini e adolescenti Ospedale di Villach CRRPS 28.851 32.160 13 PROMETHEUS Health Professional Mobility in the European Union Study 7PQ – Health – Call 09/07 EHMA 52.100 16.800 11th May 2009

43 EU Projects – Social Affairs
Titolo Oggetto Programma Leader Ref RGV Budget totale COF CE COF RVE 1 ESN - European Social network Individuazione di nuovi indicatori europei per politiche sociali contro la povertà e l'esclusione sociale Azione "Finanziamento reti attive nella lotta contro la povertà e l'esclusione sociale - DG Occupazione & Affari Sociali European Social network (UK) DirezionUe Servizi Socilai ,00 12.000,00 4.500,00 2 DEFT Elaborazione di un modello comune di intervento per operatori del settore Leonardo da Vinci - Direzione Generale "Istruzione e Cultura" Comune di vasteras (Svezia) (N.B.: partenariato ENSA) Osservatorio regionale per l'Infanzia e l'adolescenza - ULSS 3 ,00 58.500,00 43.875,00 3 PERCENTAGE Creazione di uno strumento formativo informatico per formazione degli operatori sanitari e sociali Contea del Surrey (UK) (N.B.: partenariato ENSA) Direzione Servizio Anziani e Disabilità - ULSS Rovigo ,00 30.494,00 10.165,00 4 EHLE Creazione di un kit formativo pergli operatori impegnati nell’educazione alla salute degli anziani” Grundtvig Regione del Veneto Comune di Padova + ULSS16 ,00 28.731,00 73.332,00 OPNE DOOR Interventi a favore di giovani a rischio di esclusione nell'aree metropolitane Youth in Action DG "Istruzione e Cultura" Regione veneto Osservatorio Regionale Infanzia Adolescenti Giovani e Famiglie 150576,57 9480,12 23209,19 6 DESIGN FOR ALL Corsi di formazioni rivolti ad architetti e autorità locali, nell’ambito della tematica dell’accessibilità. Leonardo da Vinci Partnerships Conseil général du Val-de-Marne Direzione regionale Servizi Sociali 11th May 2009

44 International Health and Social Affairs Office
Avenue de Tervueren, Brussels Tel – Fax International Health and Social Affairs Office Palazzo Cavalli Franchetti San Marco, Venezia Tel Fax 11th May 2009

45 Thanks For Your Attention
11th May 2009