As part of the ongoing reform of general outpatient care, the Ministry of Health published on its website the results of the assessment of the state of the public minimum network of general practitioners and primary paediatricians for the first time under the new rules and the list of districts and municipalities with allocated financial contribution.
The new method defines the network at district level and not at county level, as set out in the original standard of 2008. The number of medical places required is determined optimally and not as a minimum number. The new network is defined dynamically, i.e. the annual method of calculating the required number of doctors responds to demographic changes in the population. The necessary capacity is determined for each district and the number of unoccupied or missing medical places is calculated.
The collected summary data from the evaluation show that the network of general practitioners for adults is provided by 2 404 general doctors, where the sum of their commitments is 2 071 medical places. The average age of general practitioners is 57 years and 41% of them are 63 years or older.
A network of primary paediatricians currently provides 1,216 doctors, where the sum of their work is 993 medical places. The average age of paediatric patients is 59 years and 48% of them are 63 years of age or older. Based on the results of the Network Status Assessment in Slovakia, 400 general doctors for adults and 223 primary paediatricians are missing. The district classification ranks districts to one of 4 degrees according to the threat rate based on three classification parameters (local availability, capacity permeability and age structure of doctors). The maps of district classification are a key input to the successful address of incentives. The aim is to direct incentives to the districts, which are most critical in view of the lack of general practitioners.
Map of the district classification 2022 - General medicine
The most critically deficient districts in the expertise of general medicine include the districts of Považská Bystrica, Zlaté Moravce, Krupina and Poltár.
Map of district classification 2022 - pediatrics
The most critically deficient districts in the expertise of pediatrics include the districts of Krupina, Veľký Krtíš, Gelnica and Malacky. One of the first measures to support and stabilise general outpatient care is also a non-repayable financial contribution to the establishment of outpatient practice. The measure is financed by the resources of the Recovery and Resilience Plan under Component 11 " Modern and accessible healthcare €10 million, starting in 2022. The aim is to promote the creation of 170 general offices. The most vulnerable districts were included in the list of districts and municipalities with allocated contributions for the next period, based on the published methodology. The Ministry made a list in cooperation with the self-governing regions, which within the districts designated specific municipalities with allocated contribution in order to increase the address of this measure. In addition to the name of the municipality, the applicant also has information about the benefits offered by the municipality. For example, about the possibility of a new doctor to use the premises of the municipality to set up an ambulance, to obtain a discounted rent or housing offered by the municipality. The amount of the contribution at the level of the municipality will be 60 thousand Euro and 50 thousand Euro at the district level paid in four parts within twelve months. The conditions for eligibility of applicants as well as the conditions for payment of the contribution are laid down in Law No 578/2004 Z. z. (§ 6e). Doctors who have not yet obtained permission to operate an ambulance will also be able to apply for allowances. The purpose of the contribution is to navigate the applicants to areas where there is the greatest need and thus to influence their decision-making in the pre-authorisation period, which is already associated with the specific place of operation of the ambulance. At the same time, existing providers who intend to establish and operate a general practice may apply for contributions in addition to new doctors provided that they demonstrate the same conditions as the new applicant's doctor or pediatrician they intend to employ. The contribution aims to remove some barriers that discourage young doctors from becoming general practitioners. In addition to the low competitive status of the general practitioner, another of the obstacles is the financial bridging of the capitulation period, i.e. the periods until the conclusion of a healthcare contract with a sufficient number of insured persons to cover the income from health insurance companies.
each placement cost of a starting doctor. The list will be issued by the Ministry no later than 31 July each year, where, after assessing the state of the network and the classification of the districts for the year, it will redefine the most critical districts and the number of contributions for the new period.The contribution may be requested on the date of publication of the call, with the planned date in August. From the moment the call is published, the applicants will be able to send an official request for contribution to the Ministry. The application form together with other necessary documents will be published on the website of the Ministry of Health. For more information: https://www.health.gov.sk/?general-ambalita-care