The new State of
Health in the EU – Romania Country Health Profile 2017 – was published two
weeks ago and it reveals a concerning situation: the performance of the health
system is among the lowest in the EU, the poor and other vulnerable population groups
lack adequate access to services, the health system is chronically underfinanced.
Considering this context, I recommend that we increase the per capita health
spending for 2018, from 4.9% of GDP to at least 7.5% of GDP, and most
importantly we double the allocation to the primary health care sector.
Major findings of
the report: even though life expectancy has risen, Romania has the fourth
lowest life expectancy among EU countries and also the highest infant mortality;
cardiovascular disease and stroke continue to be the most frequent cause of
death, closely followed by cancer, despite the existing national cancer plan
and cancer screening programs; significantly more citizens with low education
do not treat their chronic diseases, rather than those with higher education; infectious
diseases such as TB and hepatitis present a major health risk; there is a
shortage of medical staff, especially in the deprived areas. The major risk
factors in Romania are behavioral: alcohol use and smoking, dietary risks
especially in the young population and low physical activity.
With 50% of Romania’s
population living in rural area, the primary health care should be the most
accessible service to the population. The vulnerable groups and poor population
access the system at a lower rate than the average. Increased funding for the
primary health care sector will motivate family physicians to move to the
remote rural areas, to reach out to a higher number of the population,
diversify the services they offer and do more preventive measures. Expanding
the primary care network and services offered will bring important and quick
benefits to the poor population. Many of the health risks and death causes are
preventable through adequate health promotion campaigns, prevention and
systematic screening programs. The family doctors should provide preventive
medical services, like early detection of cancer tests, heart disease, diabetes
and TB. Family doctors should be trained for this new services and work closely
with the social assistants of other public authorities in their area.
Legislation needs to be adapted to allow multisectoral preventive care, to
reduce the risk factors and implement national awareness and prevention
campaigns. The existing formal gatekeeping role of family physicians should be
strengthened and they should take on the coordination of care for their
patients. The government should continue their strategy from 2014 to shift the
pyramid of care and have a strong base of community and primary care.
I estimate that
doubling the primary health care funding will have measurable impact within the
next two years. The increased funding for the primary health care should be
directed to: motivate family physicians to give special attention to the poor
and vulnerable population, to move to rural area for better access for the
population, to undergo preventive activities and to have a multisectoral
approach in their activity. Substantial savings will be made from the inpatient
care as through preventive care there will be a decrease of services provided.