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

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Presentazione sul tema: "Veneto Health System Zeeland Denmark EU Office Brussels, 11th May 2009 Daniela Negri."— Transcript della presentazione:

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

2 11th May 20092 Summary Part 1 –National and Regional Health System –Regional Health Care Resources Part 2 –Objective and Priorities 2007-2009 –Waiting List Part 3 –Partnership and networks –EU Projects –Contacts

3 11th May 20093 Part 1 –National and Regional Health Systems –Regional Health Care Resources

4 11th May 20094 Veneto Region 18.390 km 2 4.8 million inhabitants

5 11th May 20095 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.

6 11th May 20096 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

7 11th May 20097 Veneto Region Social and Health Care System Organization Chart

8 11th May 20098 Veneto Health Care Model 1.Multi-tiered structure in the territory 2.Structural integration between local community and hospital 3.Integration between social and health care 4.Delegating management to local health authorities (LHA) 5.Fostering coordination between LHA, NGOs, public authorities

9 11th May 20099 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%)

10 11th May 200910 The Veneto Region is divided into 21 Local Health Authorities (LHAs)

11 11th May 200911 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.

12 11th May 200912 Financing - II Percentage of total expenditure on health according to source of revenue (2004)

13 11th May 200913 Financing - III Trends in health care expenditure in Italy 1988-2004 (billion € at 2000 GDP prices) Trends in health care expenditure in Italy, 1988-2004 Indicators198819901995200020032004 Total health expenditure in per capita US$ PPP 1 1951 3911 5352 0492 2662 424 Total health expenditure as a percentage of GDP Public expenditure on health as a percentage of total expenditure 77.679.171.972.073.775.1 Private expenditure on health as a percentage of total expenditure 22.420.928.126.524.923.6

14 11th May 200914 Regional Investment in Health & Social Services 2008 Regional budget allocation for Healthcare: € 7.2 Billion Regional investment allocated to the Social Sector: For non self- sufficient, mainly elderly citizens and other vulnerable population groups To provide services to drug addicts For financing other programmes: home care for the elderly; support to families with chronically-ill dependent; telehelp for caregivers; services for disabled people €820 M

15 11th May 200915 Veneto Region – Health Expenditure

16 11th May 200916 Part 2 –Objective and Priorities 2007-2009 –Waiting List

17 11th May 200917 Health and Social Affairs Plan 2007-2009 (1) Strategic Objectives: A.Better Implementation of Essential Level of Care Provision Reducing Waiting Lists Reduction of costs maintaining high quality B.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 C.Increasing Quality

18 11th May 200918 Health and Social Affairs Plan 2007-2009 (2) D.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 E.Improving Research and Innovation: Increase biomedical and health research; Increasing use of technology (HTA, diagnosis, …) Use of innovative managerial and organization model F.Citizenship Participation: Freedom in choosing health care providers Involvement of Third Sector Better communication

19 11th May 200919 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

20 11th May 200920 Tackling a challenge: Reducing waiting lists… National Plan for Reduction of Waiting Lists 2006-2008 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

21 11th May 200921 Reducing Waiting Lists… (2) Regional Law DGRV 300/2007 4 main objectives: 1.Definition on each prescription the specialistic visit category and maximum of waiting days allowed per category 2.Definition of 2007 targets 3.Implementation of a monitoring system 4.Evaluation of Local Health Authority Directors on the basis of the Waiting List Plan’s results

22 11th May 200922 Reducing Waiting Lists… (3) Hospital Admission CategoryDescription Maximum Waiting days Adisease tending to become emergency30 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 Ddisease without pain and disability12 months DGRV 300/2007 - : DGRV 300/2007 - Objective 1 :Definition on each prescription the specialistic visit category and maximum waiting days allowed per category

23 11th May 200923 Reducing Waiting Lists… (4) Reducing Waiting Lists… (4) Examination CategoryCategory DescriptionServiceMaximum Waiting days A disease tending to become emergency General examination10 days Specialistic examination10 days B disease with intense pain or serious disability, not tending to become emergency General examination30 days Specialistic examination60 days C disease with slight pain, without relevant disability, not tending to become serious General examination180 days Specialistic examination180 days D disease without pain and disability General examination180 days Specialistic examination180 days DGRV 300/2007 - : DGRV 300/2007 - Objective 1 :Definition on each prescription the specialistic visit category and maximum waiting days allowed per category

24 11th May 200924 Reducing Waiting Lists… (5) Reducing Waiting Lists… (5) Category31/12/200731/12/2008 Physician Office service A80%90% B70%80% C90%100% D Hospital Admission A 100% B50%90% C50%80% D 70% Oncology 100% DGRV 300/2007 - : DGRV 300/2007 - Objective 2: Definition of 2007 targets

25 11th May 200925 Reducing Waiting Lists… (6) “It’s time to care” Advertising campaign to inform citizens on their rights on waiting time for care

26 11th May 200926 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 Private Fee; Guarantees citizens’ freedom of choice; Contributes to reduce waiting lists

27 11th May 200927 Part 3 –Partnership and networks –EU Projects –Contacts

28 11th May 200928 Representative Offices of the Veneto Region Venice

29 11th May 200929 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

30 11th May 200930 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

31 11th May 200931 Participation in international networks Regions for Health Network Alpe-Adria Working Community European Observatory on Health Systems and Policies ERRIN EUREGHA

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

33 11th May 200933 Alpe Adria Working Community

34 11th May 200934 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.

35 11th May 200935 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.

36 11th May 200936 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.

37 11th May 200937 European Health Projects managed by Veneto Region 20 running project 2 in negotiation phase (Call PH 2008) 2 in evaluation (Call FP7 2008)

38 11th May 200938 European Health Projects The Budget Progetti in gestione Total Budget in € Cofinanc. CE To RV in € Cofinanc. RV in € €EC/ Budget Project RGV Health1350.949.137€2.183.102€3.487.780€38% Social Affairs 61.577.823€139.205€155.081€47% 3.300.000€ of contribution in kind

39 11th May 200939 EU Projects - Health TitoloOggetto Programma LeaderRef. RGV Budget totale in € Cofina nz. CE alla RV in € Cofina nz 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 SRSSI1.899.0008.47612.000 2 SIALON Lotta all'HIV attraverso un sondaggio tramite utilizzo di kit sperimentali Salute Pubblica 2007 Regione Veneto CRRPS - ULSS 20 Verona 714.451152.715126.720 3 CHI-CY- TOBACCO Costruire una rete di partner europei che collaboreranno insieme per affrontare le questioni legate al controllo del tabagismo. Salute Pubblica Call 2006 Liverpool Primary Care Trust (UK) Azienda USL 19 Adria, Finessi 699.41428.47363.890

40 11th May 200940 EU Projects - Health TitoloOggettoProgram ma LeaderRef. RGV Budget totale in € Cofinanz. CE alla RV in € Cofinanz RV in € 4 HEALTH OPTIMUM II Definire uno standard organizzativo/funzional eper l’erogazione di prestazioni sanitarie a distanza e sviluppare delle applicazioni di telemedicina eTen – call 2006 Regione Veneto USSL 9 – Treviso Ufficio Bruxelle s: Ronfini e Motta 19.403.5891.615.0002.566.000 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 1.127.12572.062,9967.268 6 NETC@RDS Estensione della versione sperimentale della Tessera elettronica Europea Assicurazione Malattie eTen – call 2006 Sesam Vitale EIG (Francia) USSL 13 Dolo Mirano 15.334.380102.986461.823

41 11th May 200941 EU Projects - Health TitoloOggettoProgra mma LeaderRef RGV Budge t totale in € Cofina nz. CE alla RV in € Cofina nz 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 1.900.01818.52218.523 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 Federazio ne Italiana Comunità Terapeutic he Roma Ufficio prevenzi one delle Devianze 548.22734.50036.714 9 VENICE Armonizzare i dati riguardanti le infezioni nosocomiali e la resistenza agli antibiotici in Europa Salute Pubblica 2004 Istituto Superiore di Sanità (Italia) 989.90051.92460.200

42 11th May 200942 Eu Projects - Health TitoloOggettoProgr.LeaderREF RGV Tot. Budget Cof CE a RGV Cof RGV 1010 EUnetHTA Rete europea per la valutazione dell’impatto delle tecnologie sulla salute Sanità Pubblica 2005 DACETH A Dir.Piani Progra mmi Socio- Sanitari 3.233.85817.49025.681 Euregio II Sviluppo di strategie per l'offerta di servizi sanitari trasfrontalieri Sanità Pubblica 2006 North Rhine Westfalia 00 1 INFORM Lotta all'obesità nei bambini e adolescenti Sanità Pubblica 2006 Ospedale di Villach CRRPS2.181.38628.85132.160 1313 PROMET HEUS Health Professional Mobility in the European Union Study 7PQ – Health – Call 09/07 EHMA 2.917.78952.10016.800

43 11th May 200943 EU Projects – Social Affairs TitoloOggettoProgrammaLeaderRef RGVBudget totale COF CECOF RVE 1ESN - 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 270.585,0012.000,004.500,00 2DEFTElaborazione 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 3 399.405,0058.500,0043.875,00 3PERCEN TAGE Creazione di uno strumento formativo informatico per formazione degli operatori sanitari e sociali Leonardo da Vinci - Direzione Generale "Istruzione e Cultura" Contea del Surrey (UK) (N.B.: partenariato ENSA) Direzione Servizio Anziani e Disabilità - ULSS Rovigo 414.000,0030.494,0010.165,00 4EHLE Creazione di un kit formativo pergli operatori impegnati nell’educazione alla salute degli anziani” GrundtvigRegione del Veneto Comune di Padova + ULSS16 343.256,0028.731,0073.332,00 OPNE DOOR Interventi a favore di giovani a rischio di esclusione nell'aree metropolitane Youth in Action DG "Istruzione e Cultura" Regione veneto Osservatori o Regionale Infanzia Adolescenti Giovani e Famiglie 150576,579480,1223209,19 6DESIGN 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

44 11th May 200944 Avenue de Tervueren, 67 1040 Brussels Tel +32 2 7437025 – 22 - 20 Fax +32 2 7437019 Palazzo Cavalli Franchetti San Marco, 2847 - 30124 Venezia Tel. 041 2791426-7 Fax. 041 2791366 International Health and Social Affairs Office

45 11th May 200945 Thanks For Your Attention

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