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Plan I Program Zdravstvene Zastite Na Otocima I

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REPUBLIKA HRVATSKA MINISTARSTVO ZDRAVSNA I SOCIJALNE SKRBl PLAN I PROGRAM ZDRAVSTVENE ZASTITE NA OTOCIMA I. UVOD.................................................................................................... -3 * Ill. ZDRAVSTVENA ZASTITA PO ZUPANIJAMA.. ............................................8 1. PRIMORSKO-GORANSKA ~UPANIJA 1.1 Otok Krk I.2 Otok Cres-LoSinj 1.3 Otok Rab 1.4 Mali otoci Cresko-IoSinjskog arhipelaga 2. LICKO-SENJSKA ZUPANIJA.. ........................................: ........................ .lo 2.1 Otok Pag 3. ZADARSKA ~UPANIJA..................... 3.1 Otok Pag 3.2 Otok Vir 3.3 Otoci Silba, Olib i Premuda 3.4 Otoci 1st i Molat 3.5 Dugi Otok 3.6 Otok IIi Rava 3.7 Otok Ugljan 3.8 Otok PaSman 4. SIBENSKO - KNINSKA ZUPANIJA ............................................................ 13 4.1 Otoci Zlarin, Kaprije, PrviC i iirje 4.2 Otok Murter 5. SPLITSKO - DALMATINSKA ZUPANIJA.. ................................................. .I4 5.1 Otok ~iovo 5.2 Otok Drvenik Mali i Drvenik Veli 5.3 Otok ~olta 5.4 Otok Brae 5.5 Otok Hvar 5.6 Otok Vis 5.7 Otok Lastovo 6. DUBROVA~KO-NERETVANSKAZUPANIJA.. .......................................... .I7 6.1 Otok KorCula 6.2 Poluotok PeljeSac 6.3 Otok Mljet 6.4 Otok sipan 6.5 Otoci Lopud i KoloCep I. UVOD Nacionalnom strategijom razvitka zdravstva 2006 - 201 1 godine, kao jedan od osnovnih ciljeva strategije odredeno je unapredenje zdravstvenog sustava tako da zadovolji potrebe gradana Republike Hrvatske za kvalitetnom, strueno - medicinskom zdravstvenom skrbi koja se temelji na nacelima dobre medicinske prakse. Unapredenje zdravstvenog sustava nuino ukljueuje stvaranje uvjeta kojim se ostvaruje pristupaCnost, kako teritorijalna tako i vremenska, praviCnost i jednakost pri koriStenju zdravstvenih usluga, poboljSanje kvalitete medicinskog rada te sigurnost pacijenata i zdravstvenih radnika. Teritorijalna pristupaCnost sustava zdravstva predstavlja moguknost fiziCke dostupnosti zdravstvenih kapaciteta, na naEin da su oni u dovoljnoj udaljenosti da bi prufanje zdravstvene skrbi bilo pravovremeno. Vremenska pristupaCnost zdravstvenog sustava podrazumijeva takav ustroj zdravstvenih ustanova koji omogucava prufanje hitne medicinske pomoCi u svako doba na cijelom teritoriju Republike Hrvatske. Zakonom o zdravstvenoj zagtiti (((Narodne novine)) broj 121/03, 48/05 i 85/06) definirana su osnovna naCela zdravstvena zaStite u vidu sveobuhvatnosti, kontinuiranosti, dostupnosti, te naCela cjelovitog pristupa zdravstvenoj zaStiti. Provodenje zdravstvene zaStite na hrvatskim otocima sa specifiEnim zemljopisnim, odnosno demografskim obiljeijima, prometnom izoliranoSCu, te drugim posebnim okolnostima i specifiCnostima iziskuje dodatne aktivnosti usmjerene poboljSanju pruianja svih oblika zdravstvene zaStite. Sukladno navedenim odrednicama, sveukupni je cilj Plana i programa zdravstvene zaStite na otocima unapredenje zdravlja otoCkog stanovniStva, poboljSanja dostupnosti i podizanje kvalitete svih zdravstvenih usluga provodenjem uCinkovitih mjera za unapredenje zdravstvene zaStite na otocima (kako kadrovskih, prostornih tako i organizacijskih) putem aktivnosti struCnog Povjerenstva Ministarstva zdravstva i socijalne skrbi, sudjelovanja jedinica lokalne i podruCne (regionalne) samouprave, odnosno Citavog stanovniStva Republike Hrvatske. Slika 1 II. OCJENA STANJA Danas, ukupno na otocima Zivi 117.948 osiguranih osoba. Zdravstvenu zaStitu na otocima u okviru obveznog zdravstvenog osiguranja provodi Hrvatski zavod za obvezno zdravstveno osiguranje putem 107 ugovorenih timova opCe1obiteljske medicine, 5 ugovorenih timova zdravstvene zaStite predSkolske djece, 9 timova za zdravstvenu zaStitu iena, 64 tima za polivalentnu stomatoloSku zdravstvenu zaStitu, 10 dezurnih timova hitne medicinske pomoci, 17 pripravnih timova hitne medicinske pomoCi, 21 tima sanitetskog prijevoza, te sukladno Pravilniku o uvjetima, organizaciji i naCinu rada izvanbolniCke hitne medicinske pomoCi; 12 timova hitne medicinske pomoCi, 3 tima hitnog prijevoza, 8 timova pripravnosti hitne medicinske pomoCi, 3 tima sanitetskog prijevoza. Patronainu zdravstvenu zaStitu provodi 41,5 tirnova, a zdravstvenu njegu bolesnika u kuCi provodi 28 timova. Na otocima se osim toga nalazi i 28 ljekarni (Tablica 1). SpecijalistiCko-konzilijarnu zdravstvenu zaStitu provodi 4,5 tima interne medicine; 4,7 timova fizikalne medicine i rehabilitacije; I,O tim opce kirurgije; 2,6 tima oftalmologije; 0,5 tima urologije; 1,O tim ortopedije; 1,O tim ortodoncije; 4,3 tima radiologije; 1,O tim kliniCke citologije; 0,6 timova medicinske biokemije i 4 fizioterapeuta fizikalne terapije u kuCi (Tablica 2). Tablica 2. Broj ugovorenih timova SKZZ Hrvatski zavod za zdravstveno osiguranje u okviru specijalistiCko-konzilijarne zdravstvene zaStite ugovara postupke kroniCne hemodijalize na podruCju hrvatskih otoka sa sljedekim izvanbolniCkim zdravstvenim ustanovama (sa posebnim kategorijama cijena hemodijalize ovisno o broju pacijenata kojima se pruiaju usluge hemodijalize). - : i:....................... Broj pacijenata- ............ na hemadihlizi-- 'i ...........Ciiena .usluge.. ............... ........ 1-5 I viSa za 100% i ........... ..................... ; ..... ........ i 6-10 ! visa za 50 % 1 Ugovorene hemodijalize su na slijedecim lokacijama; Primorsko-goranska iupanija: Dom .zdravlja Primorsko-goranske iupanije (Mali LoSinj i Rab) Splitsko-dalmatinska iupanija: Dom zdravlja Splitsko-dalmatinske iupanije (BraC i Hvar) DubrovaCko-neretvanska iupanija: Dom zdravlja KorCula (KorCula). Ukupan broj postelja na otocima je 46 prema Osnovnoj mreii zdravstvene djelatnosti i to za opci stacionar 40 postelja, te za ginekologiju i porodiljstvo (rodiliSte) 6 postelja (Tablica 3): Tablica 3. Broj ugovorenih postelja u stacionarima domova zdravlja Broj posblja prema Osnwn~jrnreZi zdravstvene j Dom zdravlja ukupno , . - - .. - -.. PRIMORSKO GORANSKE ZUPANIJE organizacijska jedinica Mali LoSinj PLITSKO DALMATINSKE ZUPANIJE rganizacijska jedinica Hvar ! UKUPNO Temeljem Clanka 9. Zakona o zdravstvenoj zagtiti uredeno je organiziranje i financiranje provodenja mjera zdravstvene zaStite za povecan broj korisnika zdravstvene zaStite za vrijeme turistiCke sezone. Zupanija i turisticka zajednica sudjeluju u sufinanciranju turistiCkih ambulanti. Zbog nedostatka zdravstvenog osoblja IijeCniCki timovi povecavaju se ukljuCivanjem IijeCnika iz cijele Hrvatske, koji su radno aktivni, a treba razmotriti i mogucnost angaiiranja IijeCnika u mirovini, Ciji status bi se regulirao putem ugovora o djelu. U 2007. godini izmedu iupanija, turistiCkih zajednica i zdravstvenih ustanova postignut je dogovor o naCinu organizacije rada turistiekih ambulanti na otocima s ciljem pruianja zdravstvene zagtite turistima, na slijedeci naEin: Primorsko - goranska iupanija- 4 ambulante na otoku Cres-LoSinj 2 ambulante na otoku Rabu 7 ambulanti na otoku Krku Zadarska Zupanije- 1 ambulanta na Pagu Splitsko-dalmatinska iupanija- Brae, Hvar i Vis. DubrovaCko-neretvanskaiupanija- Mljet, Janjina(PeljeSac), KorCula, Vela Luka. Za potrebe hitnog zbrinjavanja pacijenata izradena je mrela su helidroma, kako slijedi: Primorsko-goranska iupanija u funkciji su 2 helidroma: Cres, Rab; 2 zraEne luke: LoSinj, Krk Zadarska f upanija predvideni su helidromi na Molatu i Dugom otoku Sibensko-kninska iupanija predvideni su helidromi na otocima Zlarin i lirje i u predgradu ~ibenikaMandalina Splitsko-dalmatinska iupanije u funkciji su 4 helidroma na BraEu, 3 na Hvaru, 2 na Visu, 1 na solti, 1 na Drveniku Velikom, 1 na Drveniku Malom, 1 na Ciovu, 1 na Lastovu, 1 na Palagruii, 1 na S~edru,1 u Uvala PalmiZana na paklenim otocima DubrovaCko-neretvanska iupanije u funkciji su 2 helidroma na KorEuli, 1 u Blatu, u planu je gradnja helidroma na PeljeScu, u OrebiCu i na podrueju izmedu Trpnja i Janjine, te na otocima Mljetu i Sipanu. Ill. ZDRAVSTENA ZASTITA PO ~UPANIJAMA 1. PRIMORSKO-GORANSKA ZUPANIJA Na podruCju Primorsko-goranske iupanije iivi 305.505 stanovnika. Na podruCju iupanije nalazi se 9 naseljenih otoka: Cres, Krk, Mali LoSinj, Rab, Susak, Ilovik, Unije, Vele i Male Srakane. Registrirane djelatnosti su: primarna zdravstvena zaStita hitna medicinska pomoC specijalistitiko-konzilijarna zdravstvena zaStita stacionar s rodiliStem dijaliza Mali LoSinj i Rab. 1.1 Otok Krk ima 17.636 osiguranih osoba, 13 ugovorenih timova opCe1obiteljske medicine, 4 ugovorena tima iz patronaZne zdravstvene zaStite, 0 ugovorenih timova za zdravstvenu zaStitu predSkolske djece, 1 ugovoreni tirn za zdravstvenu zaStitu iena, 10 timova za polivalentnu stomatoloSku zdravstvenu zaStitu, 1 ugovoreni tirn za laboratorijsku dijagnostiku, 2 tima deZurstva hitne medicinske pomoCi, 1 tirn pripravnosti hitne medicinske pomoCi i 2 tima za sanitetski prijevoz, 5 Ijekarni, 5 izvrSitelja za zdravstvenu njegu u kuCi, a za izvanbolniEku specijalistiCko-konzilijarnu zdravstvenu zaStitu: I tirn fizikalne medicine i rehabilitacije, 1 tirn radiologije i 23 fizioterapeuta za provodenje fizikalne terapije u kuCi. U cilju poboljSanja zdravstvene zaStite na otoku Krku potrebno je ugovoriti 1 tirn za zdravstvenu zaStitu predSkolske djece, uvesti hitnu medicinsku pomoC sa standardnim timovima, razviti hemodijalizu, zaposliti jednog lijeenika specijalistu interne medicine, osigurati dolazak specijaliste psihijatra jednom tjedno na otok, a za vrijeme turistieke sezone 5 dodatnih turistiekih ambulanti (Krk, BaSka, Malinska, Punat, OmiSalj). Potrebno je razviti primjenu telemedicine. 1.2 Otok Cres-LoSinj ima 11.038 osiguranih osoba, 8 ugovorenih timova opCe1obiteljske medicine (6
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