Alem Maksuti, Danica Rotar Pavlič and Tomaž Deželan
particular, the government was charged with the neglect of changed orientations in healthcare (e.g., changed demographic indicators, the changed workload of doctors and other health workers, and the absence of analyses (6) and a regulatory mechanism for making decisions regarding people’s needs) and problems arising from the system of financing primary healthcare (7) . Ever since the early stages of Slovenia’s independence, politicians who have been making healthcare decisions have not shown a proper desire for change, which their acting according to the principle of
Objective: To determine medical doctors’ attitudes towards the implementation of the new pay-forreporting system in the public hospital sector.
Data Source: An electronic survey was conducted among 303 medical doctors in the Republic of Macedonia using the database of Healthgrouper.com, an online provider of information for healthcare providers.
Principal Findings: Majority (61.9%) of all surveyed doctors are against the proposed pay-for-reporting (P4R) reform. Disapproval is much higher among the doctors employed at the public hospitals where 79% consider that pay-for-reporting project has to be abandoned. Doctors are against the proposed P4R system that only measures quantity of the work. According to majority of the doctors current model is subjective; it opens possibilities for bias and missconduct, and puts the clinical teamwork at jeopardy.
Conclusions: Massive support against the implemented P4R reform was expressed by the Macedonian doctors employed in the public sector. The model should integrate parameters such as quality and complexity of delivered services to patients. Better integration and engagement of doctors is essential to assure support and smooth implementation of P4R reform as sound policy in practice. The Ministry of Health should set key parameters to be monitored by hospitals to evaluate the success of the P4R system.
Donka D. Dimitrova, Lubomir K. Kyrov and Nevena G. Ivanova
INTRODUCTION: Violent behaviour may be an appropriate response to a given set of environmental conditions in nature. Social organizations as power systems ensure stability through force or threat. However, there is a growing concern about the violence against health service staff in both hospitals and outpatient facilities.
AIM: To study the frequency, types and determinants of patient violence towards health professionals in primary care in Bulgaria and to fi nd the specifi c characteristics of violent behaviour in patient subgroups as well as the attitudes of providers.
MATERIAL AND METHODS: A sample of 165 doctors from primary care institutions in Bulgaria participated in a questionnaire study using a specially developed research tool.
RESULTS: Prevalence of violent patient behaviour has not been studied extensively in Bulgaria leaving a gap in research data. The participating physicians, however, reported that there is a serious increase in the frequency and diversity of aggressive behaviour towards medical profession by patients and negative attitude of the general public indicating serious issues in public health care.
CONCLUSION: Most often patients’ aggression was provoked by factors associated with the health system organization and effectiveness and the socio-economic status of the population.
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The materials presented in this article are the result of a documentary-bibliographic study, which is based on the use of methods of analysis, synthesis, comparison and generalization. The results of the study have shown that the problem of professional ethics and culture of health care professionals is of significant interest. Problems of ethics, culture and deontology are the subject of consideration by scholars from the countries of Europe and the United States. There have been defined the main modern tendencies of training doctors for their professional activity in the leading countries of the world in the context of the professional and ethical competence formation. It has been found out that the development of higher medical education is carried out on the basis of the Bologna process principles, which involves introduction of two degrees (Bachelor and Master of Science), implementation of the ECTS system, introduction of the single diploma supplement, etc. It has been estimated that the educational programs for future doctors' training are aimed at the development of the students’ analytical and critical thinking; behavioral and social sciences, medical ethics, bioethics, provide knowledge, skills and abilities in the field of communication, clinical decision making, application of ethical norms, work in the multi-staff teams etc. The integrated programs play an important role in the educational process. Over the last decades studying bioethics is a compulsory component of the medical education. However, not only bioethics is the basis for the formation of future doctors’ professional and ethical competence at medical Universities abroad. The Oath of Hippocrates is of great significance for the students who devote themselves to medicine. In various countries it has been transformed into codes, oaths, etc., and now it is carried out by the students (future physicians) during their studies at higher medical educational institutions.
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