FERM 2024 | Message from Adrian COSINSCHI, Manager of Câmpulung Moldovenesc Municipal Hospital

Health Panel

Module III – Financing methods for public hospitals, 18th edition of the Moldova Regional Economic Forum, Vatra Dornei, 2024

SPEAKER – Adrian COSINSCHI – Manager of Câmpulung Moldovenesc Municipal Hospital

THEME: „Financing methods for public hospitals”

In his presentation at the „Moldova Regional Economic Forum 2024”, Dr. Adrian Cosinschi, manager of Câmpulung Moldovenesc Municipal Hospital, highlighted a significant issue in the public health system: the challenges faced by small and medium-sized hospitals under the current legislation. „Why not also SMM?” was the question he raised, emphasizing the need for a dedicated structure for small and medium-sized hospitals (SMM) to address their specific needs.

Impact of current regulations

Dr. Cosinschi described how current regulations affect small hospitals, using the mountainous area of Suceava County as an example, where three small hospitals are located and the lack of on-call services in pediatrics and obstetrics-gynecology creates a state of constant risk. „The concrete consequence of these regulations is that in the mountainous area of Suceava County, where three small hospitals operate: Vatra Dornei Municipal Hospital (183 hospital beds), Câmpulung Moldovenesc (246), and Gura Humorului Town Hospital (113), there are no longer on-call services in pediatrics and obstetrics-gynecology, resulting in a state of increased permanent risk in managing maternal-infant emergencies”, Dr. Cosinschi explained.

This situation is exacerbated by the considerable distances to larger hospitals, adding additional difficulties for the local population.

Proposing a solution

To address these issues, Dr. Cosinschi proposed the creation of an autonomous administrative unit for the mountainous area. According to the hospital manager, this territory, with a population of over 150,000 and more than 500 hospital beds, could benefit from a “new autonomous health administrative unit” to manage maternal-pediatric emergencies.

„By simplifying, the Mountain Area, an extensive and remote territory from larger county hospitals, with a combined population of over 150,000 and with over 500 hospital beds in local hospitals, would have sufficient statistical arguments to be assimilated into a new autonomous health administrative unit, capable of independently managing maternal-pediatric emergencies”, Adrian Cosinschi mentioned, emphasizing that this model could reduce demands on the County Hospital.

Financial and legislative challenges

A crucial aspect of this proposal is the legislative framework and financial support required. Dr. Cosinschi acknowledged that „the cost of covering the payment for on-call doctors cannot be supported individually by any local hospital.” Moreover, motivating specialist doctors is essential. The doctor proposed that incentive bonuses should exceed the level of on-call payments at their own hospital and include reimbursement for travel expenses.

Role of Câmpulung Moldovenesc Municipal Hospital

Among the options for the location of regional on-call services, Dr. Cosinschi considers that Câmpulung Moldovenesc Municipal Hospital is a suitable candidate due to its strategic location and existing facilities. „Câmpulung Moldovenesc Municipal Hospital, due to its central geographical position and the most hospital beds, could be a candidate for conducting regional on-call services”, Dr. Cosinschi noted, also mentioning the operation of an ICU and the presence of a SMURD helicopter pad.

Conclusion

Dr. Cosinschi concluded with a call to county health and administrative authorities to consider his proposals, noting that „we intend to express our concern about solving a high-impact public health issue.” The proposed solutions reflect a clear vision of the need for reforms in the health system, keeping the needs of patients in disadvantaged areas at the forefront.

Dr. Adrian Cosinschi emphasized the importance of these changes for improving access to medical care in mountainous and disadvantaged areas, bringing up a crucial topic for the future of the public health system.