Description (EN): The project ROcHUs aims at bringing radical improvement in the general conditions of healthcare system in Satu Mare county (SM) and Szabolcs-Szatmár-Bereg (SSB) county. These two bordering counties - and especially Satu Mare county - are facing relevant lagging in the field of healthcare related problems and challenges.
In SM there are multiple problems overlapping and causing organic problems linked in negative feedback: SM is the county with the lowest life expectancy at birth among the counties of Romania, SM is highly affected by the internal and external emmigration of healthcare specialists, the less developed healthcare infrastructure makes the SMCEH even less attractive for the young doctors. This administrative handicap is doubled by infrastructural shortages. SMCEH functions in two locations, the "Old
Hospital" situated in Eroii Revolutiei square in a building erected in the 1910s, and the "New Hospital" situated at Ravensburg street, put up in the early 1970s. The two locations are at approx. 2,5 km distance and the transport between them is possible only through the crowded centre of the town, causing serious problems, especially for the three interventional departments located in the "Old hospital": Neurology, Internal medicine and Ophtalmology. The newer pile of buildings - the "New Hospital" - puts
also restraints on adaptation and development possibilities, also on complying with the present legal requirements regarding the necessary surface allocation per hospital beds and those necessary for assuring the legally required circuits. This limitative infrastructural asset is also limitative for the medical development chances and for the ability of SMCEH to attract young doctors. Another serious infrastructural constraint is the unsuited heliport of the SMCEH, that has no permanent authorization and is
operable only in daylight conditions. The heliport is situated in the courtyard of the SMCEH and the permanent authorization can not be obtained because of the high surrounding buildings. The emergency situations that need urgent transport to other medical units have to use the 15 km distant Satu Mare airport in low visibility situations. All these circumstances contribute to the fact that SMCEH has the highest intra-hospital mortality on national level - a situation that cannot be left unaddressed by remedy intentions.
The two Hungarian partners Szabolcs-Szatmár-Bereg County Hospitals and University Hospital (SSBCHUH) and Hospital of Felső-Szabolcs (HFS) cover together the entire territory of SSB county. The most relevant shortages of these two partners were targeted in order to ensure enhanced medical service level for the population of SSB county. As a general tendency the cardiovascular diseases cause the highest number of fatalities, although in the western states of the EU and also in the USA a considerable drop of this death causes have been registered, showing partly statistical relation with the general development level of the society. In Hungary this lowering tendency - due to healthier life style and enhenced medical services availability - appeared in the Western counties whilst the poorer areas of SSB or Nógrád
are lagging behind in facing this challenge. With this respect it is significant to compare the door-to-balloon times (indicator that shows a time measurement in emergency cardiac care, specifically in myocardial infarction situations - the interval from the patient's arrival in the emergency department till a catheter guidewire crosses the culprit lesion for the cardiac catheterization), that is 39 minutes in national average and 63 minutes for the Hospital in Níregyháza, part of SSBCHUH. It is the highest value of the 19 main hospitals that have such data measured. As a main death cause, improvement of this situation is of urgent priority for SSBCHUH and for the inhabitants of SSB county.
HFS functioning in Kisvárda is a key actor in health-care for the micro-region of Felső-Szabolcs, the only microregion of SSB not covered by basic hospital services by SSBCHUH. The main challenge for health-care level enhancement in this area is assuring the diagnose precision in the laboratory phase as a basis for almost every later stage of diagnose and treatment.
The lagging level of health-care services is thus the main common challenge the present project addresses, by investments to overcome the above described shortages: extending the actual main building of SMCEH by a new wing that assures the necessary space for moving the interventional departments to the same location and for creating the necessary medical circuits for all the existent medical departments therein, and above its 6th floor a new heliport to be built in order to assure the proper
transport facility for urgencies. SSBCHUH will reduce the door-to-balloon times by procuring performant medical instrumentation in the Vascular Center. HFS will refurbish and equip its general laboratory.
Beyond the investment components the existing cross-border tele-diagnose network will be developed and the new instrumentation put in function in SSBCHUH will be place for practice modues for the SMCEH specialists for professional training.
The two counties' medical specialists will have the opportunity to know each others work and the special challenges of a particular domain in a bigger picture, in the framework of an annual Cross-border Medical Conference organized in Satu Mare each year with different thematics, with the participation of both local and well-known specialist of the particular domain. The focus will be on the cross-border character, emphasized on the list of invitees and speakers.
The above goals are followed by the most adequate partnership, the health-care institutions and county level administrative authority responsible for this public service in the two neighbouring counties as the two ministries reponsible for health expressed their support for the project.
The project will contribute this way to deliver indicators as follows: on SM part a total no. of 14 departments will be directly and poistively influenced by the foreseen investment, SSBCHUH manages the instrumentation development of two departments, whilst HFS will realize the refurbishment and equipment facilities of the its general laboratory (one department).
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Expected Outputs (EN): Main expected results of the present project are the following:
- enhanced medical service level in 14 departments of SMCEH;
- enhanced medical service level in 2 units of SSBCHUH;
- enhanced medical service level in 1 unit of HFS;
- access to improved health services for the population of Satu Mare and Szabolcs-Szatmár-Bereg counties.
The project result indicators are totally in line with the result indicators set for this priority axis of the Programme. The two indicators defined on Programme level for this Investment priority are: 9/a1 Population having access to improved health services and 9/a2 Number of health-care departments affected by modernized equipment ROcHUS project has activities that will result a considerable enhancement of the medical service level for departments in SMCEH (
1. Urgency Receiving Unit,
2. Pharmacy,
3. Pediatric surgery and orthopedics,
4. Urology,
5. General surgery,
6. Plastic surgery and microsurgical reconstruction,
7. Central surgery block,
8. Sterilization,
9. Blood transfusion Unit,
10. Neurology,
11. Anesthesia and intensive care,
12. Orthopedics and Traumatology,
13. Anatomical Pathology Service,
14. Internal medicine), two departments of the SSBCHUH (
1. Vascular surgery unit of the Surgery Department,
2. Cardiology division of the Internal medicine Department) and 1 unit at the HFS (General laboratory). This way the project contributes directly to reach the Programme level indicator 9/a2 for this call of 32 units by 53.12%, targeting the enhancement of the medical services in a total number of 17 units of the three partner hospitals. Regarding the indicator 9/a1 the project assures access to improved health services for the population of the two target counties, that is a total of 903,632 inhabitants (values of 2011). It represents 27.34% of the Programme target value for this indicator for this call.
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