At beet, we are actively involved in shaping the concept of Centres of Integrated Care (CIS). These are partnerships that bring together health and social care in one common space, with the aim of improvement and access health and social care.
Several reasons motivate the implementation of the Integrated Care Centres project. Among the most important ones are:
From the successful implementation of the CIS project we promise:
We are currently working on the design of a strategy for a network of Regional Centres for Integrated Health Care (RCIS) and Centres for Integrated Health Care (CIZS), with calls for the creation of these centres expected to be published in the second half of 2023.
Integrated care refers to partnerships that bring together health and social care in one shared space (physical or virtual). The project aims to both improve and simplify access to health and social care and improve the quality of care provision for different types of patients (long-term ill, acute, chronic and those with special needs). This care is provided in Integrated Care Centres (hereafter also referred to as 'CIS').
CIS can be simplistically seen as a conceptual successor to the former health centres/clinics that aimed to provide the necessary outpatient and social services in a given region. They are characterized by several features, the most important of which are that CIS:
In the current primary health care system, there is no effective referral of patients within the different types of health care provided. Within this inefficient patient routing, there is a lot of duplication in the provision of healthcare, with primary care physicians playing a key role in capturing and directing the patient for a particular health problem. At the same time, the continuity and interconnectedness of general practitioners and specialists is important for better access to care and, ultimately, patient adherence to the system. The link between health and social care is also essential.
The creation of integrated centres with a multidisciplinary portfolio of health and social services also reflects and follows the announced changes in the optimisation of the hospital network (support for the outpatient sector and patient management in the primary sphere will enable regulated referral of patients within inpatient health care).
The intention to create a network of integrated health care centres was also defined in the Strategic Framework for Health Care 2014-2030. Among the priority activities proposed for the defined period were:
RCIS (Regional Integrated Care Centres) - programme period 2021-2027
In creating a network of integrated care centres, the MoH has started the creation of Integrated Health Care Centres (hereinafter referred to as "IHCCs")
52 346 627 €
Projects in process
Contracted eligible expenses
The primary objective of establishing the CIZS was to strengthen primary health care in unattractive regions. This will secondarily be reflected in lower pressure on the hospital sector. It will also ensure greater efficiency and the provision of health services that are cost-effective and efficient with long-term sustainable financing. At the same time, the elimination of duplication and overuse of specialised and inpatient care is a priority.
Basic parameters of the CIZS project
The funding source was allocated funds from the Integrated Regional Operational Program for the period 2014-2020 (IROP) within priority axis 2, specific objective 2.1.2 - Modernize the health infrastructure for the purpose of integrating primary health care.
A comprehensive methodological guide for project preparation and successful operation of CIZS is summarized in the document Methodology for the implementation and operation of the Center for Integrated Health Care - as part of Annex V04 to calls for CIZS (https://www.mpsr.sk/vyzvy/376).
Out of 72 approved applications for NFA, 25 projects have been successfully finalised, another 40 are in the process of implementation with an estimated completion date by the end of 2023. 7 projects will eventually not be implemented (contract not concluded/project did not contribute to the OP objectives). The final number of contracted CIZS projects is thus 65.
The total contracted amount represents the value of € 52 574 774, while the average amount of the total contracted amount per CIZS amounted to approximately € 809 thousand, including the applicant's co-financing of almost € 40 thousand.
In the contracted CICUs (65), the dentist (in 89% of the CICUs), the internist (in 23% of the CICUs) and the FBLR (in 22% of the CICUs) have the largest share of representation, in addition to the mandatory components (VLD, VLDD and gynecologist). The widest range of health care specialties (not including ADOS) is offered by the CIZS Nováky in the Trenčín Region (12), the CIZS Žarnovica in the Banská Bystrica Region (10) and the CIZS Kolárovo in the Nitra Region (10). Social care is integrated in 29 CIZS.
Considering the success of the CIZS project implemented in the IROP 2014-2020 programming period The Ministry of Health of the Slovak Republic continues the CIZS project.
The primary objective of the continuation of the CIZS project is to Strengthening health and social care in the regions. Mandatory provision of health and social services will contribute to accessibility in prevention, diagnosis, treatment and care of patients at the local community level.
Unlike other health facilities such as polyclinics, the CIZS integrates not only the provision of outpatient health care but also the provision of social services on a daily basis. This means that the patient/client has everything under one roof and does not have to travel to another place, address or even another city for examination or service provision.
This integration leads to better communication between healthcare providers, patients, social service providers and clients
The continuation of the CIZS project has allowed room for the introduction of innovations that were not included in the original CIZS project.
As health care creates the conditions for early identification of social disadvantage (there is often a correlation between ill health and social disadvantage), in all CIZS built from the new project period there will be compulsory basic social counselling.
In addition to this mandatory component, the CIZS will be able to support other social components, either on an outreach or outpatient basis.
Healthcare delivery should be responsive to current digital trends. Therefore, the CIZS needed to integrate relevant eHealth modules in accordance with Act No. 153/2013 Coll. on the National Health Information System.
The CIZS will also support software, applications and digital tools for remote patient management (telemedicine).
In the context of the Slovak healthcare system, there is an assumption that fewer and fewer doctors will be caring for an increasing number of patients. This will result in capitation tribes with a higher number of patients, where there will be more patients per doctor than the norm.
The continuation of the CIZS project responds to this current as well as projected shortage of health personnel by building premises for junior medical and non-medical staffwho is expected to take over from the doctor or nurse in the future.
The source of funding is allocated funds from the Operational Programme Slovakia 2021 - 2027 under the specific objective RSO 4.5.
Comprehensive methodological guidance for project preparation and successful operation of the CIZS will be published in Q3 2023.
The Integrated Care Centres project continues with the development of Regional Centres for Integrated Care (RCIS). These larger health facilities integrate the mandatory components of health and social care with innovative administrative and digital support.
Comprehensive guidance on project preparation and successful operation of the RCIS will be published in Q3 2023.
Finalisation of the methodology for the operation of the RCIS.
Communication with potential eligible applicants for non-repayable financial contribution (NFA).