For the purpose of defining a new norm for the public minimum network of specialist outpatient gynaecological care providers (currently Annex 2) Regulations of the Slovak Government No. 640/2008 Coll. on the Public Minimum Network of Healthcare Providers), the Ministry of Health of the Slovak Republic prepared as a first step an analysis of the state of specialised outpatient gynaecological care (GYN), which was the starting point in the development of a new public minimum network for GYN.
Source data were provided by self-governing regions, health insurance companies and the Health Care Supervisory Authority. Data on providers and personal security of ambulances were analysed on 1.3. 2022. For the other indicators, the reporting period was 2019 as in 2020 and 2021 specialised outpatient care was affected by the COVID-19 pandemic.
In order to objectively identify the state of the network and to propose the calculation of the new norm for the public minimum network GYN, the following parameters have in particular been analysed:
- Number of GYN contractors
- Number, age and amount of doctors in GYN
- Total number of visits, capitalised insurance, their age and time-consuming treatment
- the migration of insurance within districts.
For the purposes of the analysis, the contractor GYN was considered to have concluded a valid and effective contract on the provision and reimbursement of healthcare with at least one health insurance company in the Slovak Republic on 1.3. 2022.
State of the public GYN network(as at 1.3.2022)
Based on the results of the analysis, 584 GYN providers and 721 gynaecological ambulances were registered in the Slovak Republic on 1.3. 2022, providing health care for 797 doctors with an average age of 57 years (Table 1.2). Almost 39% of total liabilities are made up of doctors aged 63 and over.
Further findings show a low quality of commitment data. Data reported by gynecologists to health insurance companies differ significantly for the same provider. In many cases, the sum of the doctors' gynecologists' commitments was higher than 1,00 medical places, with only the work of gynecologists operating in outpatient providers being included in the sum of the work. If a gynecologist was also on a full-time basis in another type of healthcare (e.g. institutional health care), they did not enter the calculation.
Where the sum of the gynaecologist's obligations in all gynaecological offices where the reported time was higher than 1,00 medical places, his total time was adjusted to 1,00.
Table 1: Specialised outpatient gynaecological care providers
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| COUNTRY | Number of providers | Number of ambulances | Number of doctors | Number of medical places (s) |
|---|---|---|---|---|
| Banská Bystrica region | 68 | 95 | 97 | 71 |
| Bratislava region | 91 | 107 | 151 | 99 |
| Košice region | 8 3 | 98 tablets | 116 | 89 |
| Nitra Region | 78 | 96 | 101 | 79 |
| Prešov region | 76 | 92 | 98 tablets | 79 |
| Trenčín region | 60 | 70 | 72 | 59 |
| Trenčín region | 57 | 74 | 84 | 61 |
| Žilina region | 79 | 89 | 96 | 81 |
| Slovak Republic | 584 | 721 | 797 | 618 |
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Table 2: Age structure of outpatient gynecologists
Import Page 2302 - Table 2
| Age group Number of doctors Number of medical places (s) 33-39 years 78 50 40 - 49 years 146 107 50 - 59 years 207 172 60 - 69 years 223 189 70 - 79 years 128 94 80 years and over 15 6 Total 797 618 | Number of doctors | Number of medical places (s) |
|---|---|---|
| 33-39 years | 78 | 50 |
| 40-49 years | 146 | 107 |
| 50-59 years | 207 | 171 |
| 60-69 years | 223 | 189 |
| 70-79 years | 128 | 94 |
| 80 years and over | 15 | 6 |
| Total | 797 | 618 |
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