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SMHM -
Volume 2
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Todor Fimkov, MD, MBA Despite widely spread arguments regarding urgent need for implementation of cost-containment efforts by NHIF and other financing parties, the problem of hospitals’ purchasing practices for medications stays in shade. There is, however a simple method for internal cost containment that could be realized by the hospital itself. Using data from IMS and utilizing simple common sense logic, we can speculate that hospitals still can realize about 4 to 6% saving from their expense budget. The prime question here should be – are all brand medication innovative? Quick review of facts shows that not all brand medication are innovative (they do not expand current therapeutic width, they do not significantly improve quality of life etc.), but hospitals tend to spend more on them. No doubt, 6% saving will not substitute for the fresh capital needed by hospitals, but could optimize the way hospital entities handle their medication purchasing practices. Furthermore – utilizing more generic medication will make the healthcare services and medications more accessible. Key words: generic drugs, hospital treatment, accessibility, hospital market, market segmentation, market dynamics |
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SMHM -
Volume 2
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Assoc. Prof. Petko Salchev, MD, PhD The modern hospital is very important and in the same time very expensive and visible element of the health care system. It is possible to evaluate the hospital care by the different qualities and quantities indicators. This gives opportunities to analyze effectiveness of the used resources (effectiveness evaluation) and assessment of the qualities of the services (quality evaluation). In this article are presented and compare two basic models for hospitals evaluation: Benchmarking and DEA (Data Envelopment Analysis). The basic requirements for this evaluation are presented with their opportunities and weaknesses. Analyses are made with the data from Ministry of Health internet site for 10 top hospitals. The main conclusion: 1) Health care system have a need for evaluation of health services and establishments which should to evidence based. 2) The patients have needs for real information about health services and insurance funds; 3) There is a new and modern methods for the effectiveness evaluation both the hospitals and another institutions – universities, insurance funds, wards etc. 4) Both of these methods have a different opportunities and weaknesses. 5) Implementation and using is easy; 6) There are a trained staff and programs for implementation; 6) To put in practice these methods require a resources and time which means that this is not possible without a governmental support. Recommendation – Development of the independent center for quality evaluation with the support from government and non-governmental institutions. Key words: effectiveness, hospital, benchmarking, evaluation, quality |
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SMHM -
Volume 2
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Arseni Arseniev The main diagnostic and therapeutic methods used in Ayurveda are presented in this article. The Ancient Indian diagnostics consists of 1. analysis of the social (and geographical) life conditions, 2.an evaluation of the biological specifications and 3. psychological characteristics. The autor pays attention to face diagnostics - lips, tongue, eyes, pulse diagnostics etc. The therapeutic methods consist of herb treatment. dieting, metal and mineral treatment and flower treatment. In ayurveda the relaxation therapy is devided between 1 physical (exercise, massage, relaxing asanas - yoga postures), 2 mental (meditation - samadhi, music therapy - gandharva music etc.).The autor also presents the famous in Ancient India form of treatment of the tocsins also known as Panchakarma or the five actions. |
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SMHM -
Volume 2
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Assist. Prof. Nikolai Hristov, MD The article is an attempt at an introduction to Japanese healthcare. Its historical developments, strong and weak sides, are all represented. The majority of medical service providers are private, but any forms of market or competition are absent. The present situation demonstrates well the folly of leaving healthcare on an autopilot, without securing any levers for influence beforehand. Key words: Japan, healthcare, national health system. |
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SMHM -
Volume 2
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Elia Georgieva, MD, assistant professor in Department of Social Medicine and Health Care Management The cardiovascular diseases are the leading cause of death and disability in Bulgaria. They cause lots of psychosocial problems, which affect the quality of life of the involved persons. The aim of this article is to outline the association between depression and social support and cardiovascular diseases. Depression is a common problem in persons with diseases of the heart and is a curable condition. The early diagnosis of depression is important for the successful recovery and better psychosocial rehabilitation of the involved persons. The lack of social support is related to unfavourable prognosis after a heart disease. The success of the cardiovascular rehabilitation depends on the insurance of social support and the involvement of the family members. Key words: heart disease, depression, social support. |
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