Background: Slovenian perinatal results are compared with European results: sometimes they are in the higher, sometimes in the lower range. Analysing trends and comparisons with other countries helps ...in planning changes in organisation and function so we are prepared for future challenges. Introduction of new technologies demands appropriate answers to challenges, including ethical ones. Methods: We compared perinatal results in Slovenia from 1987 to 1996, the PERISTAT project results from the year 2000 and the EURO-PERISTAT project with 2004 perinatal results including the Slovenian. Results: Some of the more prominent Slovenian perinatal results are shown. Cesarean section rate is the lowest among 26 countries in Europe. Deliveries after artificial reproductive techniques are second most frequent. Teenage pregnancies are very rare. Seemingly high maternal mortality mirrors also strict recording and cross checking with other data bases. Relatively high stillbirth rate may reflect the fact that all induced labours for fetal malformations are recorded. Conclusions: In Slovenia we do have tools for quality collection of perinatal results which should be used and audited. To have comparable results inside Slovenia, definitions should be written at http://www.obgyn-si.org/. When changing delivery record markers of prenatal care should be added – they could be easily obtained from maternity booklets (electronic or paper). In maternity booklet there is a place to write about grand dad prostate cancer; let us replace it with risk factors for preterm delivery (medical history and cervical length), 12 weeks screening for preeclampsia and intrauterine growth restriction (ultrasonic and biochemi- cal markers), gestational diabetes and obesity (body mass index, waist – hips ratio) and hypothyroidism; let us leave some free space for the future screening tests. Known and proven efficient management (e.g. progesterone for recurrent preterm delivery prevention) should be used.
Primary health care systems (PHCS) can be highly effective at meeting the healthcare needs of people with chronic or multiple morbidity. Under the right conditions it is also the best setting to ...assess health more generally and to intervene when health risks are identified. For people with an established chronic disease, primary care is also the natural setting to coordinate care and to ensure that patients receive the right balance of specialist vs. generalist input - care that is effectively coordinated can improve the overall quality of care by minimising the need for unnecessary and costly acute care, and by improving patient satisfaction. But how is it possible to measure the configuration of a health system and how do the essential features of health systems relate to quality of care? This paper provides an overview of how this might be approached and discusses the challenges therein.
Sistemi primarnega zdravstvenega varstva so lahko zelo učinkoviti pri zadovoljevanju zdravstvenih potreb ljudi s kroničnimi ali več sočasnimi boleznimi. Pod pravimi pogoji so tudi najboljše okolje za splošno oceno zdravja ter za izvajanje ukrepov, ko prepoznamo tveganja za zdravje. Za ljudi s kroničnimi boleznimi je primarno zdravstvo tudi naravno okolje za usklajevanje nege in zagotavljanje ravnovesja med specialistično in splošno oskrbo. Zdravstvena nega, ki je učinkovito usklajena, lahko izboljša splošno kakovost tako, da stremi k zmanjševanju potreb po nepotrebni in dragi akutni negi ter k izboljšanju zadovoljstva bolnikov. Toda, kako izmeriti konfiguracijo zdravstvenega sistema in ugotoviti, na kakšen način bistvene značilnosti zdravstvenih sistemov odražajo v kakovosti zdravstvene nege? V prispevku predstavljamo možne pristope in razpravljamo o izzivih, ki se nanašajo nanje.
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