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L ithuanian Health System in the Context of Global Health

L ithuanian Health System in the Context of Global Health. Vytenis Povilas Andriukaitis Minister of Health of the Republic of Lithuania Astana , 24th of May 2013. LIETUVOS RESPUBLIKOS SVEIKATOS APSAUGOS MINISTERIJA. Map of Lithuania / Data for 2012. Population ( thous .) 2993.5

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L ithuanian Health System in the Context of Global Health

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  1. LithuanianHealthSystemintheContextofGlobalHealth Vytenis Povilas Andriukaitis MinisterofHealthoftheRepublicofLithuania Astana, 24th ofMay 2013 LIETUVOS RESPUBLIKOS SVEIKATOS APSAUGOS MINISTERIJA

  2. MapofLithuania / Data for 2012 • Population (thous.) • 2993.5 • Liveborn • 34068 • Birth rate per 1000 pop. • 11.4 • Deaths • 40914 • Mortality per 1000 pop. • 13.7 • Naturalincrease per 1000 pop. • -2.3 • Net internationalmigration per 1000 pop. • -7.2

  3. RegionsofLithuania: 10 Countiesand 60 Municipalities Siauliai county 293 831 Telsiai county 149 148 Panevezys county 244 714 Klaipeda county 333 896 Utena county 147 629 Taurage county 107 496 Kaunas county 527 225 Vilnius county 807 620 Marijampole county 158 121 Alytus county 153 854 Source. Statistics Department of Lithuania, 2012

  4. Legal Basis • Constitution of the Republic of Lithuania (Article 53) • Law on the Health System • Law on Health Care Institutions • Law on Health Insurance • Law on the Rights of Patients and Compensation for the Damage to their health • Law on Pharmacy • Law on Public Health

  5. LifeExpectancy at Birth, inYears Source: Statistics Lithuania

  6. AgeDependencyRations:Children (aged 0-14) &Elderly (aged 60 andolder) per 100 PopulationAged 15-59 Source: Statistics Lithuania

  7. Main Causes of Death in 2011 Males Females Source: Institute of Hygiene, Causes of Death Register

  8. Infant Mortality per 1000 LiveBirths1991 - 2011 (WHO)

  9. Maternal Mortality in Lithuania in 1990-2011 (100000 live births)

  10. Incidence and Mortality from MalignantNeoplasmsper 100 000 Population Source: Institute of Oncology of Vilnius University, Cancer Register

  11. Age AdjustedDeathRates per 100 000 European Standard PopulationDiseases of the CirculatorySystem

  12. Notified TuberculosisCases in Lithuania New cases and relapses(abs. numbers) MDR-TB (Multi-Drug Resistant Tuberculosis)Prevalence in Lithuania (abs.n.)

  13. Number of PersonsInjured and Died in TrafficAccidents Source: Lithuanian Traffic Police

  14. Number of MedicalPersonneland HospitalBeds in 2011 * - professionally active personnel ** - excl. nursing, psychiatry, rehabilitation and tuberculosis beds Source: Institute of Hygiene

  15. NumberofHospitalBedsinthePeriod 1965-2011 Source: Institute of Hygiene

  16. Expenditure on Health as Percentage of GDP Source: Statistics Lithuania. Since 2004 data is calculated according to OECD metodology

  17. Expenditure on Health(million EUR) according to OECD Methodology of System of Health Accounts Source: Statistics Lithuania

  18. Compulsory HealthInsurance in Lithuania Source: National Health Insurance Fund under the Ministry of Health

  19. Examples of GoodPracticeand InternationalCollaboration in Lithuania • Lithuanian National Perinatal Programme • Interventional Cardiology Programme

  20. TheLithuanianPerinatalProgrammestartedin 1992 The aim of the Programme: • to reduce the stillbirth rate • to reduce the neonatal mortality and morbidity • to reduce the infants mortality and morbidity

  21. The LithuanianNational Perinatal Programme Collaboration of Swiss Confederation and Republic of Lithuania 1990 registrations ofbirths according to WHO 1999 Programme of Perinatology, with financial support from the Swiss Government 2012 The Swiss-Lithuanian cooperation programme - a special attention for mother’s and child’s health

  22. TheThreeLevelsofRegionalizationSystem : • level I - district hospitals • level II - regional multidisciplinary hospitals • level III - 2 Perinatal Centers - in Vilnius and Kaunas

  23. - VILNIUS PC - KAUNAS PC Regionalization of Obstetricaland NeonatalCare • 2 Perinatal Centers with Neonatal Intensive Care Units (NICU)

  24. Achievements

  25. Achievements (II) • Registration of live birth according WHO (1990) • Regionalization of Perinatal and Maternal Health care (1992) - 2 Perinatal centers - neonatal and maternal transportation - medical birth register (1993) - perinatal audit - gradual closing of small maternities

  26. Interventional Cardiology in Lithuania 1 2 1 3 4+1 12 Cathlabs machines for PCI Procedures,40 interventional Cardiologists, 3 centers working 24/7 (Vilnius, Kaunas, Klaipeda)

  27. InterventionalCardiologyCentersin Lithuania • 6 interventional cardiology centers • Over 400 cardiologists in Lithuania, 10% are interventional cardiologists • 6600 Pacemaker interventions (PCI); 1500 Primary PCI • 690 thromobolysis(tenecteplase,actilyse) • Tenectoplasestarted being performed from the year 2006 180 km 80 km 130 km 200 km 100 km

  28. Coronarographies in Lithuania 2005 - 2012

  29. PCI in Lithuania 2005-2012

  30. Coronarographies and PCI in Lithiania 2000-2012

  31. East and South-EastLithuania Cardiology Program Acute coronary syndromes side • Aim: • To reduce the acute myocardial infarction hospital mortality • To improve the specialized cardiac care for not only Vilnius inhabitants, but also for the inhabitants of surrounding regions • Fundedfrom: • EU StructuralFunds • StateBudget • National Health Insurance FundBudget

  32. Methods • Education of qualified medical staff: medical doctors and nurses. • Funds for the cardiology equipment not only in Santariskiu hospital, but also in local hospitals in surrounding regions. • Creation and implementation of diagnosis and treatment algorithms according to evidence based medicine. • Patients are transported from 22 local hospitals

  33. Transportation of Patients with STEMI from Eastern Lithuania to Vilnius University Hospital Mortality in Utena district decreased from 23 % to 7% in last 5 years Vilnius University PCI Center Population in East and South-East region of Lithuania : 1 290 844 Mortality in Alytus district decreased from 24 % to 7%

  34. Thank you for your attention

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