seminar on financing health care for the poor hospital contributions

Seminar on Financing Health Care for the

Poor

Hospital Contributions to those Who Could Not Effort

Dr. Nu Nu ThaMedical SuperintendentYangon general Hospital

U N I O N OF M Y A N M A RM I N I S T R Y O F H E A L T H

D E P A R T M E N T O F H E A L T H

YANGON GENERAL HOSPITAL1500 BEDDED HOSPITAL

Free Medical Care - Government Budget

Cost sharing - Essential drugs – revolving fund

Chargeable Cases Cost-sharing programs for services FOC

Financial ResourcesBudget- - limited amount - rules & regulationsTrust Funds - only for medicineOther Account (OA) – rules &

regulationsDonations from well-wishers

Patients in YGH

Out PatientsSpecialist OPDScheduled time table on respective daysRequire referral from primary health center or

secondaryhospitalsFacilities for investigations - Imaging - LabMedicines – out of pocket

Admission to the respective wards for further treatment

Accident & Emergency

Round the clock service for acute cases of medical, surgical and trauma.

Provide live saving urgent services as well as minor trauma and surgical cases

23 hour service started since 1.1.2010.Mainly trauma cases.

Supporting Facilities for A& E

Radiology X-Rays, Ultrasound, CT, MRI

Lab24-hour cost sharing lab (fully auto

)

Medical Social WorksMedical Record

Department

Total Attendance of Out-Patients By Speciality [2010]

Specialty New Old Total Attendances

As % of Total Attendances

Specialists' OPD 7981 30320 38301 18.42

Radiotherapy + Medical Oncology 6037 54993 61030 29.35

Nuclear Medicine 10295 16463 26758 12.87

Physical Medicine 7888 6856 14744 7.09

Dermatology 9468 11603 21071 10.13

Special Skin 1252 4332 5584 2.69

Dental OPD 8007 5076 13083 6.29

Plastic Maxillo Facial & Oral 809 1886 2695 1.30

Pain Clinic 204 743 947 0.46

Epilepsy Centre 52 272 324 0.16

Emergency Receiving Centre . I 12089 - 12089 5.81

Emergency Receiving Centre . II 11342 - 11342 5.45

Total 75424 132544 207968 100.00

Total Attendance of Out-Patients By Speciality [2010]

Specialty New Old Total Attendances

As % of Total Attendances

Specialists' OPD 7981 30320 38301 18.42

Radiotherapy + Medical Oncology 6037 54993 61030 29.35

Nuclear Medicine 10295 16463 26758 12.87

Physical Medicine 7888 6856 14744 7.09

Dermatology 9468 11603 21071 10.13

Special Skin 1252 4332 5584 2.69

Dental OPD 8007 5076 13083 6.29

Plastic Maxillo Facial & Oral 809 1886 2695 1.30

Pain Clinic 204 743 947 0.46

Epilepsy Centre 52 272 324 0.16

Emergency Receiving Centre . I 12089 - 12089 5.81

Emergency Receiving Centre . II 11342 - 11342 5.45

Total 75424 132544 207968 100.00

Main OTH = 5115

Emergency OTH = 2544

Trauma OTH = 2520

Neuro OTH = 907

Thoracic OTH = 1544

Cardio Vascular OTH = 494

Plastic Maxillo-facial OTH = 1381

Total Surgical Operations = 14505

Surgical Operations by O.T.H. [ 2010 ]

Definition of “a poor patient”

FOC- Urgent & emergency

cases- Government employees- poor

Fund raising - well wishers

Income generation - rental fees - cost sharing

programs

Cost sharing Programs for Services

Room fees - for private rooms

- Lab investigation

- Imaging - X-rays - Ultrasounds - CT - MRI

Cardiology- Cath lab – angiogram- ECHO- ETT

Gastro-enterology- Scopy

Haemo-dialysis

Room fees 25%-25%-25%-25% 50%-50%

InvestigationsX-rays - for continuous supply of filmCT, MRI, US - 100% - maintenance fund

Lab - Main lab & 24-hr lab - reagents and equipment

Cath-lab - cardiac catheter - ECHO - ETT

Entero-scopy – 100% - maintenanceHaemo-dialysis -

Medicines - donations in kinds - cash for emergency case - trust funds…..>1L - local ward funds

Diet – hospital diet encouraged self diet

EMERGENCY

Those who could not effort - Drip & Drip sets (3 ½ L)….OA- E Oth 2L (4”, 6” bandage &

cotton, and anesthesia drugs) - A&E (POP, Emergency drugs)

- Surgical Operations … direct donation

All FOC ( including Investigations)

Role of Medico-social workers

& allotted budget (05 03)

Sanction 9Appointed 2Trained personals (ward

sisters)

Patient

Investigations

Accommodation

Drugs

Diet

The story is all about good management .

Essential elements of management

Drive Thinking ability Communication ability Human relation ability Technical ability

1. Drive Responsibility Vigor Initiative Persistent Healthy

2. Thinking ability Original thinking Critical thinking Creative thinking Analytical

thinking

3. Communicative ability Listening and verbal

comprehension Oral and written communication

4. Human relation ability Ascendancy ( feeling and acting as a

leader) Emotionally stable Sociability ( establish a working

contact with environment) Cautiousness (must be able to see

other person's view to take it into consideration)

Cheerfulness

5. Technical ability Must have additional

training, expertise and understanding the specific techniques, tools, activities and problems of the department.

Find ways to analyze and change processes to improve quality, which is the focus of TQM.

In fact in the present situation there’s a lot of ways & means to provide free medical care for those who could not effort .