​Regional Study Tour on Primary Health Care

Venue: Slovenia, January 2019

Please find below the key findings:

  • Slovenia has 63 health centers with 490 health posts. Mostly public (77%), dentistry in concessions (23%). Compulsory health insurance fund is covering 99% of expenses, however out of pocket payment is increasing. 8.1% of GDP (2017), more than 2/3 goes to PHC
  • The life expectancy is nearly at EU 28 level, however the healthy life years are considerably lower. IMR is at 1.8 (EU 28: 2.6) due to highly qualified midwifery. In average the Slovenian population increased its life expectancy in the last decade by 1 year within 4 years.
  • Primary Health Care (PHC) is under the responsibility of municipalities, however many functions in health (incl. health financing) remain centralized.
  • In 2011 a system of family medicine (so called model practices) was introduced. These practices include in addition to the regular nurse, a specialized nurse on chronic disease for the management of chronic disease patients for monitoring of patients health status, prevention and health promotion.
  • Health promotion centers (HPC) were created in 2002 across all HC in Slovenia. Between 2013 and 2016 Norvegian funds were used for piloting specific services for vulnerable groups. New partnership models including NGOs and social services is now upscaled and EU funded.
  • The newly upgraded HPC include multidisciplinary teams of nurses, physiotherapists, psychologist, dieticians and kinesiologists. Pediatricians are included for children.
  • Specific vertical programmes (Breast-, cervical, colorectal cancer prevention programmes, nutrition, anti-tobacco, HIV) brought down the respective morbidity and mortality data in the last decades in an impressive way. For the three cancer programmes, there are specific steering committees with MoH, HIF and specialized NGOs meeting. The role of NGOs in advocacy is considered important.
  • Institute of Public health establishes for all municipalities municipal public health profiles that shall serve as the evidence for municipalities to design their health interventions accordingly.
  • Integrated care is in its beginning only. Currently there is a EU funded project with risk population on alcohol abuse ongoing.
  • Mental health is community based with multi-disciplinary teams, new legislation in place since last year.
  • Strategic plans of health centers (5years) approved by municipal council. Quality Assurance in health centers along 28 indicators (condition, process, outcomes). Supervision takes place internally and through the professional chambers. Quality department is nurse led. MoH supervises additionally. Continuous medical education is accredited by chamber
  • IT led processes are crucial for monitoring and evaluation.

 

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