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Healthcare to be Revamped

From 2011 to 2015, the number of hospital beds in Uzbekistan decreased from 139,800 to 129,800. New reductions will continue until 2020. True, this will be related solely to anti-tuberculosis service. Will there be enough hospital beds for all those in need of them?

The situation was clarified at the Chair of Organization, Economics and Administration of Healthcare of the Tashkent Institute of qualification improvement of physicians.

It turned out that this tendency was laid down into the State program 18 years ago. Already then had been clearly specified the major transformations to be carried out in the sphere of medical services to the population of the country.

They were prioritized in the following order: primary medical-sanitary health care, protection of maternal and child health, emergency medical aid, specialized medical assistance, sanitary-epidemiological welfare of the population, provision of medicines and so on.

The modernized healthcare system of the country gives priority to the outpatient rather than inpatient service as was the case in the past. A true vector of this concept had been recognized very soon, first of all, by industrially advanced states and they took to implementing it in their respective countries.

The course of these transformations and their initial results are being actively analyzed in many countries of the world. The majority of experts admit the positive impact of reduction of the number of hospital beds on the development of healthcare system in general. Time, however, has not come so far for categorical statements; the long-term results of these transformations will have to be seen yet.

What hospital beds are subject to reduction, and what will replace them? Head of Chair “Organization, Economics and Healthcare administration” Damin Asadov helped us clarify the issue.

“Specialists consider that time has come today to introduce a thorough control over the justification of the need to hospitalize a patient. Patients who may be treated on an outpatient basis should not be sent to hospitals. Undertreated patients should not be also discharged from a hospital or high turnover of hospital beds should not be achieved on account of hospital overload work by sacrificing sanitary-hygienic conditions.
There are always patients who may well be treated efficiently outside the hospitals. It has been established that in such areas as “therapy”, “nursing the elderly patients”, as well as a number of other specialities the proportion of unjustified cases of admissions for inpatient treatment makes up more than 20-27%, while the share of patients for whom hospital treatment is no longer useful after a certain period is equal to14.6% for all specialities, except psychiatry and obstetrics.
This indicator exceeds 60% for patients getting treated at therapeutic departments and sections nursing the elderly patients at general type municipal hospitals.

The results of some scientific research provide evidence that 20-30% of patients getting treated at inpatient hospitals may receive more effective and cheaper medical assistance at day care centers and at their homes.
Let us refer to upcoming reductions, which are planned to be carried out up to the year 2020. Why are they related to anti-tuberculosis service? Optimization of the network of establishments has been continued in this area with simultaneous elimination of low-capacity and expansion of modern well-equipped hospitals. At the same time, the Ministry of Healthcare keeps introducing modern methods of treatment at the recommendations of the World Health Organization, which enable certain group of patients to get safe treatment in outpatient conditions at home. Thus, the need in 1450 hospital beds will drop out after the realization of these projects, and their number will be gradually reduced, according to specialists.
Experts also pay attention to the fact that it has been becoming more and more evident in recent years that the systems providing a patient the opportunity to immediately take a specialist advise after the initial appeal (France, Germany, Sweden, USA) shows the tendency towards higher costs compared with that where there is a link between a patient and specialist doctor in the person of a general practitioner (Denmark, Finland, the Netherlands, UK).

Resources saved on account of reducing the inefficiently used hospital cots in Uzbekistan are channeled to the development of the system of general practitioners and introduction of modern high technological methods of diagnostics and treatment at medical establishments, which enable to reduce time required for recovery of patients.” 
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