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Report Referring to the Human Resources Costs

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Report Referring to the Human Resources Costs R E P O R T referring to assess the costs related to health human resources Designed by Oleg Galbur consultant assistance in developing local human resources strategy and action plan for implementation Chisinau 2011 C O N T E N T S Introduction ….................................................................................................. 3 Financial resources allocated to the health........................................................ 4 Financial resources allocated to medical education ........................................... 6 Financial resources allocated payroll employees in the health system............. 10 Salaries of employees of different health system sectored............................... 14 Financial resources payroll employees’ work in health system............ .............20 Employee’s wages in the district Centers of Family Doctors………......... ……...... 25 Conclusions.................................................. ................................................... 30 2 Introduction To the evaluation report in respect of expenditure relating to human resources in health include the results of analysis of various aspects of health system financing human resources chapter, such as resources allocated to the health system, health expenditure per capita, training expenses, payroll, including comparison with other sectors of the economy depending on the GDP, the link between wage levels and the density of health workers. The report was prepared based on following sources: - Information submitted by the Budget and Finance Policy Directorate of the Ministry of Health - Financial reports and other relevant information available on the website of the Ministry of Health (www.ms.gov.md) - Information available site of the National Bureau of Statistics (www.statistica.md). - Information available on the website of the Ministry of Finance (www.mf.gov.md). Along with assessments of financial aspects in the report are presented information regarding the number of employees in different sectors of the health system (primary care, emergency care, hospital care) or depending on the status of health care institutions (municipal, republican). Information on the payroll are presented including salaries compared with other branches of national economy (education, transport, construction) but also in relation to average wage. 3 Financial resources allocated to the health system Thus, analysis of the volume of financial allocations to the health system received during the last decade show that this indicator has suffered a significant and growing. According to data published by the National Bureau of Statistics, only in 2000-2005 financing of the health system increased from 471.9 million. up to 1572.4 million, which represents an increase of less than three. The same growth trend continued in coming years, reaching in 2009 the amount of 3846.9 million., representing an increase of over eight times compared with the year 2000 (Chart no. 1). Chart. 1 Evolution of total expenditure for health care (million lei, NBS) Therefore, taking into account that faces the bed, on 01 January 2009, resident population (people on evaluation / recording live permanently with permanent residence in that locality) of the Republic Moldova was 3565.604 thousand people, we can say that the health of every citizen that year were spent on average by about 1079 lei. The share of health expenditure in the consolidated budget (total revenues and expenditures of state and local budgets, formed as independent elements in the budget) in the reference period ranged from a low of 11,3% in 2005 and 15,3% in 2002, settling in the dynamic growth continues a trend since 2005 (Chart no. 2). 4 Chart. 2 Share of health spending in the consolidated budget and gross domestic product (NBS) A dynamic upward clearly attests to the valuation of the share of health spending in gross domestic product (GDP), which is the main national accounting and macroeconomic aggregate is (the final result production activity of resident producer units and corresponding value of goods and services produced by these units for final consumption). Thus, if health expenditures in 2000 constituted only about 2.9% of GDP, then by 2009 this indicator reached 6.4%, which is an increase of 100%. In this context it is noteworthy that the continuous increase in financial allocations for the health system was conducted on background reduction in the period 2002-2009, the number of hospitals from 110 to 83, the absolute number of beds in hospitals from 24,443 to 21,938, but the degree of assurance to the population of 67.6 hospital beds / 10 000 inhabitants up from 61.6 / 10 thousand inhabitants. At the same time, the reference period increased significantly the level of funding primary medical care sector and emergency medical care, these are considered as priorities in health system development. 5 Financial resources allocated to medical education Another objective of the study in question was to assess the volume of financial resources for medical education and pharmaceutical organization, including different categories of funding and education (environment, education, postgraduate, continuous). Thus, for organizing medical and pharmaceutical education in 2008 at the expense of state budget resources and special centers account funds have been spent in total amounting to 197307,9 thousand lei, and in 2009 this indicator amounted to 250497,9 thousand or about ¼ longer than the previous year (Chart no. 3). Chart. 3 Financing of medical education in 2008-2010 (thousand lei) At the same time, it is important to note that the total expenditure for higher education organization in the state budget were covered only about 60% annually, while the remaining about 40 % were covered from the special funds, from fees for basic studies in different types of contractual services, etc.. The data in question shows that medical education funding in the reference period was below the actual needs, is complemented with the account is considered as sources of special, enabling efficient organization and conduct of 6 medical education, but did not provide conditions for sustainable development and establishment strategic objectives and long term, providing considerable investment in this area. Thus, in 2008 the state budget for higher education health care funds have been allocated in the amount of 54596,4 thousand lei, and for medical education programs have been allocated to 34684,2 thousand lei, and in 2009 for both education budget allocations were increased by about 20-25%, trends that have continued in 2010. But these increases were essentially focused on restoring the initial level of funding of medical education, given that in 2008, budget expenditures were reduced in all areas of economic and financial crisis. The same trends were found and in finance education year postgraduate studies secondary residency and clinical studies, that funding has increased from 42222,5 thousand lei in 2008 to 53721,6 thousand lei in 2009. Much has been modestly funded continuing vocational training, which was allocated only 4636,7 thousand lei in 2008 and 5223,7 thousand lei in 2009, and the absolute level insufficient funding during the last decade has contributed to the degradation absolutely necessary for this form of training medical field of professional activity (Chart no. 4). Chart. 4 Medical educations funding the state budget in 2008-2010 (lei) 7 It is important to mentioned that during 2006-2008, the admission was made exclusively for specialty medicine with budget financing studies on contract basis shall remain in force only for specialties Dentistry and Pharmacy (total 150 seats) and therefore the expense of special fund has been significantly reduced. Thus, only since 2008 has resumed coverage of expenses in an amount greater than the expense of special funds that have been 40,930,600 lei for medical education scared lei 12455,5 thousand for medical education environment. For 2009 the volume of these funds in higher education increased by like 20% and the average medical school has decreased by approximately increased by about 10%, a reduction in demand for registration number fee. Specific financial ways volume for postgraduate education and, in particular that have continuously been so insignificant that they do not have influenced the forms of training (Chart no. 5). Chart. 5 Financing medical education at the expense of special funds in 2008-2010 (thousand lei) Therefore, the results of evaluations conducted in medical education financing chapter demonstrates that it was funded; in general, only the current needs. 8 In recent years, about 40% of expenses were covered from the special funds, which work effectively confirm that medical educational institutions is directly dependent on the volume Financials funds from sources other than the budget, and these circumstances do not provide conditions conducive to sustainable development and environmental quality of higher and medium medical education. In this context, it is important to maintain that education funding in Moldova volume is only a differentiated by categories of education (higher and specialized e), and within higher education are not differentiated approach depending on the complexity its various branches. Regardless of education such as medicine, teaching, law, agriculture, engineering, etc.., financial policies are identical and the same principles apply in the allocation of financial resources, while medical education is much more
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