CONDITIONS FOR PROVIDING MEDICAL SERVICES WITHIN SPITALULUI ORĂȘENESC PANCIU
In accordance with the Order of the Minister of Health and of the President of the National Health Insurance House, Ministry of Health Order No. 3/2024 remains valid throughout the period of validity of Order of the Minister of Health and of the President of the National Health Insurance House No. 1,857/441/2023 approving the Methodological Rules for applying Government Decision No. 521/2023 approving the service packages and the Framework Contract governing the conditions for providing medical care, medicines and medical devices within the social health insurance system, as subsequently amended and supplemented. (Under art. 2 of Ministry of Health Order No. 3/2024, in force from 26 January 2024) for 2024 – 2025, Panciu Town Hospital provides medical services in the form of:
- continuous hospitalisation – a form of admission through which preventive, curative, rehabilitative and palliative medical care is provided for the entire period needed to fully resolve the case, with a hospital stay of more than 12 hours;
- day hospitalisation – an alternative to continuous hospitalisation for patients who do not require medical supervision for more than 12 hours per visit (day).
The medical care provided at Panciu Town Hospital under continuous hospitalisation comprises acute care and chronic care and is provided in compliance with the following.
ADMISSION CRITERIA:
- medical and surgical emergencies and situations in which the patient's life is endangered or may be, requiring continuous medical supervision;
- diseases with endemic-epidemic potential requiring isolation and treatment;
- patients falling under art. 109, 110, 124 and 125 of Law No. 286/2009 on the Criminal Code, as subsequently amended and supplemented, and in cases ordered by prosecutor's order during trial or criminal investigation, who require isolation or compulsory admission, and the treatment of persons deprived of liberty for whom the court has ordered that the sentence be served in a prison hospital, as well as the treatment of prison patients whose conditions require monitoring and reassessment in prison hospitals;
- the diagnosis cannot be established and the treatment cannot be carried out and/or monitored on an outpatient basis or in day hospitalisation.
The factors to be taken into account cumulatively when deciding on admission for continuous hospitalisation:
- the severity of the signs and symptoms presented by the patient
- the medical predictability of a negative, undesirable course for the patient
- the need for and availability of diagnostic tests/investigations
- the exhaustion of diagnostic and therapeutic resources in the other areas of medical care
Patients presenting an admission note for continuous hospitalisation may be scheduled for admission, depending on the condition and the severity of the signs and symptoms presented and on the availability of services at the requested hospital.
The prevention of continuous hospitalisations considered avoidable will be achieved through early diagnosis, appropriate management, treatment and monitoring, and adequate supervision, on an outpatient basis and in day hospitalisation, as applicable.
HOSPITAL MEDICAL SERVICES PROVIDED UNDER DAY HOSPITALISATION
- last a maximum of 12 hours per visit (day), but not less than 2 hours per visit (day), except for services provided in emergency rooms and emergency units within hospitals whose funding does not come from the Ministry of Health budget, and for services provided for oncological and haemato-oncological conditions. All medical services and surgical procedures must be provided within the interval from the opening to the closing of the day hospitalisation record. Otherwise, the service provided is not reimbursed. (point amended by art. I pt. 25 of Ministry of Health Order No. 739/2024, in force from 31 January 2024)
THE CRITERIA FOR DAY HOSPITALISATION ADMISSION ARE:
- medical and surgical emergencies requiring medical supervision for up to 12 hours under the conditions laid down in these rules, only in inpatient healthcare facilities that also provide hospital medical care under continuous hospitalisation
- the diagnosis cannot be established and the treatment cannot be carried out and/or monitored on an outpatient basis
Hospital medical services are provided to insured persons on the basis of the admission note issued by:
- the family doctor
- the specialist doctor in outpatient healthcare facilities, regardless of their form of organisation
- doctors in medical and social care units
- doctors in private dialysis centres under contract with the health insurance houses, as applicable
- doctors working in TB dispensaries, mental health laboratories, mental health centres and psychiatric day units, and dental practices not under contract with the health insurance houses, which are part of hospitals as units without legal personality
- occupational medicine doctors
The following situations are exempt from the provisions of the paragraph above:
- a) for continuous hospitalisation:
- birth
- medical and surgical emergencies
- diseases with endemic-epidemic potential requiring isolation and treatment
- patients falling under art. 109, 110, 124 and 125 of Law No. 286/2009 on the Criminal Code, as subsequently amended and supplemented, and in cases ordered by prosecutor's order during trial or criminal investigation, who require isolation or compulsory admission, and the treatment of persons deprived of liberty for whom the court has ordered that the sentence be served in a prison hospital, as well as the treatment of prison patients whose conditions require monitoring and reassessment in prison hospitals
- for patients requiring long-term hospital medical care – years
- cases recommended for hospital admission following a medical letter issued by doctors in the integrated outpatient department, under Decision 521/26-05-2023, of that hospital, who are under contract with the health insurance houses
- intra-hospital transfer where the type of care changes
- inter-hospital transfer
- patients who have a medical letter on discharge indicating that they should return for admission
- patients with haemophilia enrolled in the national haemophilia programme
- patients with a confirmed oncological diagnosis enrolled in the national oncology programme
- b) for day hospitalisation:
- medical and surgical emergency;
- monitoring and administration of treatment for conditions requiring the administration of medicines corresponding to the INNs marked 1, 1b and 1W, provided for in Government Decision No. 720/2008, republished, as subsequently amended and supplemented, administered parenterally under special supervision; the tariff does not include the specific medicines corresponding to the INNs marked 1, 1b and 1W, provided for in Government Decision No. 720/2008, republished, as subsequently amended and supplemented;
- monitoring of patients with HIV/AIDS;
- dynamic assessment of the viro-immunological response;
- monitoring and treatment of patients with thalassaemia;
- monitoring of oncology patients;
- administration of treatment for rabies prophylaxis;
- monitoring of primary genital syphilis and secondary syphilis of the skin and mucous membranes;
- resolution of cases recommended for hospital admission following a medical letter issued by doctors in the integrated outpatient department of that hospital who are under contract with the health insurance houses;
- patients who have a medical letter on discharge indicating that they should return for admission;
Patients presenting an admission note may be scheduled for admission, depending on the condition and the severity of the signs and symptoms presented and on the availability of services at the requested hospital, regardless of the form of hospitalisation.
Preventive, curative and chronic hospital medical services include:
- consultations
- investigations
- establishing the diagnosis
- medical and/or surgical treatments
- care, rehabilitation, medicines, medical supplies
- accommodation and meals, as applicable, depending on the type of hospitalisation
DOCUMENTS REQUIRED ON ADMISSION:
- An admission note from the family doctor or specialist doctor, or a medical letter for admission from the outpatient specialist doctor
- A valid identity card
- A valid health card
- A certificate from the Health Insurance House for patients who have not been issued a health card or who for certain reasons do not have one;
Additional documents required, by patient category:
- Employees: A standard certificate (original) from the workplace showing insured status and the number of sick leave days taken in the last 12 / 24 calendar months
- Pensioners: The pension slip (if possible from the month preceding admission) (original or photocopy)
- Co-insured: A standard certificate (original) confirming co-insured status and that the person supporting the co-insured pays the contribution due
- Pupils: over 18 years and students and young people under 26 years if they have no income from work: a certificate confirming pupil/student status or a copy of the pupil/student card stamped up to date
- For patients included in the national health programmes: Medical certificate issued by the attending doctor or by the coordinating doctor of the health programme
- Unemployed: Identity document and the booklet and/or certificate issued by AJOFM Vrancea
- Social assistance beneficiaries: Identity document and a certificate issued by the town hall confirming social assistance status under Law No. 416/2001
- Persons with a certified degree and type of disability: Identity document, disability certificate, periodically endorsed, and the document issued by the tax authorities showing that they have no taxable income
