New safety requirements to ensure better availability and quality

The Ministry of Health initiated changes for supportive care and nursing service requirements that are coming into force as of October. This will enable to ensure a better quality of inpatient care. Based on the new procedure, patients that cannot take care of themselves and are in need of constant supervision of healthcare staff, will be provided with supportive care and nursing services regardless of the disease. The new order will regulate the work load on nurses and nurse assistants thus protecting them from a burnout.

‘According to practice, the majority of patients choose care services at home and there’s even a saying that home helps you recover faster. Considering this fact, we aim to hospitalise patients only when there is no possibility for them to receive the services at home. This is why we initiated changes not only in the development of at-home services, which is highly ranked by the residents themselves, but also inpatient supportive care and nursing.’ said Danguolė Jankauskienė, Vice-Minister of Health.

She drew attention that should a patient be hospitalised for inpatient supportive care and nursing, the possibility of treating them at home will be re-evaluated every 30 days.

The increasing need for care services at home is also illustrated by the data of the National Health Insurance Fund (NHIF) – the number of patients receiving outpatient services at home (43,430) is currently nearly twice as large as hospitalised inpatient service receivers (22,910). According to NHIF experts, this gap is likely to keep increasing, as the demand for outpatient services is increasing every year. For example, the number of these services, provided last year, was 1 million and 181 thousand, while in the nine months of this year – already 1 million 328 thousand.

The new procedures also apply to the workload of the healthcare staff, providing supportive care and nursing services (the workload standards used to be only recommendatory before) – patients will be taken care of more nurses and nurse assistants. These changes are introduced not only with the aim to ensure the availability and quality of the care services, but also in order to evade staff burnout due to possibly excessive workload.

Moreover, the new requirements will ensure more attention to hospitalised patients with care needs or dementia. The fact that due to their specific needs, these patients will be treated at separate adapted divisions, is an important change.

The advancement of the inpatient supportive care and nursing services should also be fuelled by financial incentives: as of October this year, institutions providing inpatient supportive care and nursing services will receive higher reimbursement rates.

As of 1 October, the basic price for a bed-day, paid to institutions of general care services will increase by nearly 50 per cent, making 68.06 Euro per bed-day. According to NHIF data, the number of these services last year was the highest, making more than 96 per cent of all nursing and supportive care services. Moreover, the price of vegetative-state patient care has been increased by 64 per cent as well, making to 97.02 Euro. There is also a new service – demented patient care. The basic price per bed-day will be 91.08 Eur.

It should be noted that the increased supportive care and nursing services will apply to healthcare institutions that comply with the new service provision standards. The compliance will be evaluated by the State Health Care Accreditation Agency under the Ministry of Health.

The decision to offer higher prices for supportive care and nursing institutions that sign an agreement with their THIF territorial division, undertaking to comply with the new requirements in a transition period, which cannot exceed 3 months, is an important incentive for the changes too.

All institutions, offering or intending to offer supportive care and nursing services will have to comply with the new requirements until 1 January 2024.
According to THIF data, the reimbursement of the increased prices for supportive care and nursing services will require more than 36 million Euro from the Compulsory Health Insurance Fund every year.

(BNS photo)

Information from NHIF and the Press Service of the Ministry of Health

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