Algorithm for Forecasting the Number of Hospital Beds by Specialty Using Regression Equations.

Introduction:Planning the hospital beds according to population needs is still in focus. Objective: To develop an algorithm for designing the number of beds Per hospital and specialty wards according to local needs. Materials and methods: The present study was designed as a retrospective analysis based on hospital utilisation data, demographic data and morbidity recorded by GPs in J2 county, testing the variation in dependent variable (number of beds) due to independent variables, using linear regression analysis. Results:Three models were tested, of which model 3 version 2 was considered the most relevant one, providing a general regression equation for type I hospitals, but also for different hospital wards, taking into account local data regarding morbidity on specialty wards and local demographic data; when uploaded with own data of type I and IV hospitals, the number of beds forecasted by regression equations provided differences in specialty ward bed numbers, comparing with the approved structure. Conclusions:The algorithm for planning the hospital beds on specialty wards provided by the present study can be used to either forecast the structure of hospital beds for new hospitals or redesign the current ones according to the population needs.

Burden of Chronic Heart Failure in Romania.

Chronic heart failure (CHF) affects millions of people across the world, with increasing trends in prevalence, putting ever increasing pressure on the healthcare system. The aim of this study was to assess the financial burden of CHF hospital care on the public healthcare sector in Romania by estimating the number of inpatient episodes and the associated costs. Additionally, societal costs associated with missed work and premature death of CHF patients were also estimated. The national claims database was analyzed to estimate the number of CHF patients. Cost data was extracted from a pool of nine public hospitals in Romania. In 2019, 375,037 CHF patient episodes were identified on specific wards at the national level. The average cost calculated for the selected nine hospitals was EUR 996. The calculated weighted national average cost per patient episode was EUR 1002, resulting in a total cost of EUR 376 million at the national level. The cost of workdays missed summed up to EUR 122 million, while the annual costs associated with the premature death of CHF patients was EUR 230 million. In conclusion, the prevalence of CHF in Romania is high, accounting for a large proportion of hospitalizations, which translates into large costs for the national payer.

The Development of the Romanian Scorecard HTA System.

OBJECTIVES: To present the characteristics of the scorecard health technology assessment (HTA) implemented since 2014 and to show the results of this HTA process by the end of 2015. METHODS: The health care context and the Romanian HTA legislation were studied while considering the reasons behind HTA introduction, the key stakeholders, and the HTA process as a whole. A critical appraisal was done covering public HTA reports and the decisions made by the Ministry of Health. RESULTS: The scorecard HTA model is in place from 2014 and is based on six criteria: France HTA decision, UK HTA decision, Germany HTA decision, the number of European Union countries with reimbursement, the development of a local real-world data study, and a budget impact assessment. By December 2015, more than 200 HTA dossiers were evaluated and the scorecard HTA results were reflected in three processes of the drug reimbursement list update. Consequently, 25 new drugs, 11 fixed-dose combinations, 2 new indications, and 4 orphan drugs received unconditional inclusion, and 5 drugs received conditional inclusion via commercial arrangements. Moreover, the scorecard system was used for delisting drugs: 16 were delisted and another 21 were moved to a lower level of reimbursement (20%). CONCLUSIONS: The implementation of the scorecard HTA started in 2014 using combined information from Romania and other countries. Although the scorecard HTA system makes no direct evaluation of the value of drugs, authorities consider it to be effective, being designed only to favor cost-saving drugs and to promote high discounts.

[Medium-term strategy for the specific management of pneumology hospitals and wards after the decentralization of the sanitary system]. / Strategie pe termen mediu privind managementul specific al spitalelor si sectiilor de pneumologie dupa descentralizarea sistemului de sanatate.

Identifying and promoting new management techniques for the descentralized pneumology hospitals or wards was one of the most ambitious objectives of the project "Quality in the pneumology medical services through continuous medical education and organizational flexibility", financed by the Human Resourses Development Sectorial Operational Programme 2007-2013 (ID 58451). The "Medium term Strategy on the specific management of the pneumology hospitals or wards after the descentralization of the sanitary system" presented in the article was written by the project's experts and discussed with pneumology managers and local authorities representatives. This Strategy application depends on the colaboration of the pneumology hospitals with professional associations, and local and central authorities.

Retrospective analysis of use and distribution of resources in otolaryngology wards in Romanian hospitals between 2003 and 2008 to improve provision and financial performance of healthcare services.

AIM: To analyze use and distribution of resources by otolaryngology (ENT) hospital wards in Romania between 2003 and 2008, in order to plan the improvement of patient access to health care services and health care services' financial performance. METHODS: Clinical electronic records were searched for all patients discharged from all public hospitals funded on a per-case basis by the government between January 2003 and September 2008. Adult and pediatric ENT wards, as well as ENT wards from different counties, were compared. RESULTS: The number of ENT hospital beds and the number of specialists decreased from 2003 to 2004, the number of specialists declined, and specialists were distributed unevenly among the hospitals and counties. The total number of ENT wards was over 100 for almost the entire study period, but there were only about 15 pediatric ENT wards in all 42 counties. ENT wards recorded more cases and hospitalization days than oral-maxillofacial surgery and neurosurgery wards, but fewer cases than general surgery or obstetrics wards. ENT wards had the lowest mortality rates. Until the second half of 2007, adult ENT wards had a lower surgical index, higher complexity of cases, and longer average length of stay than pediatric ENT wards (P<0.001, t-test). After 2007, pediatric ENT wards treated more complex cases (P=0.004, t -test) that were less surgical in nature; this result was due to the shift from the Health Care Finance Administration classification diagnostic-related group (DRG) system to the Australian Refined DGR system, as well as to improper use of codes. ENT wards in different counties differed in the number of cases, average length of stay, and case mix index. CONCLUSION: Statistics and case mix clinical data may be a good starting point for informing hospital management to assess ENT service coverage, but they should be supplemented with data on hospitalization costs.