Medical-economic reasonings on the reform in the field of state surveillance of public health

Abstract

Background: The functional organization of the service, institution or organization requires adjustment to challenges of the social, economic, and professional environment that intervene development stages of society. This is also true for the Public Health Supervision Service. Material and methods: The results are based on evidence of historical achievements, statistical activity data in public health surveillance, the disease prevention, data on managers’ opinion about ways to streamline institutional work, including some results of the economic activity of the institutions. Results: The diminished activity in the prevention of non-communicable diseases is determined by the scarce budget for public health surveillance activities, the lack of staff and the inappropriate approach of the methodology for monitoring environmental factors in relation to the health of the population. Service overloading 1.2-1.4 times to the functional standard, driven by low wages and as a result of staff exodus, has a negative impact on effective indicators of public health coverage. The current model of non-communicable disease prophylaxis, with a particular focus on increasing healthcare investment, does not contribute to improving the population’s health indicators. Conclusions: The functioning of the Public Health Surveillance Service under the conditions of insufficient budget with dispersion of the existing number of institutions does not contribute to the efficiency of public health surveillance. The results of the study, also the health and economic indicators in the health system point to the need for institutional reform to adjust the public health surveillance and financial support for disease prevention activities under the new conditions.