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Implementation of the Patient Rights' Act

Country: 
Slovenia
Partner Institute: 
Institute of Public Health of the Republic of Slovenia, Ljubljana
Survey no: 
(15) 2010
Author(s): 
Tit Albreht
Health Policy Issues: 
New Technology, Pharmaceutical Policy, System Organisation/ Integration, Quality Improvement, Others, Access, Responsiveness
Others: 
Patient rights
Reform formerly reported in: 
Patient Rights' Act
Current Process Stages
Idea Pilot Policy Paper Legislation Implementation Evaluation Change
Implemented in this survey? no no no yes yes no no

Abstract

Patients' Rights Act was an important piece of legislation with which Slovenia finally regulated this important area. After a long public and parliamentary discussion the act was passed and was also well accepted soon after its adoption.The most important achievements are in: defining complaint pathways, introducing a no-fault procedure, influence patient integrity protection in all other legislation. Soon after its adoption a process of adapting all relevant legislation to this new act started.

Recent developments

The new Patient Rights' Act introduced a new philosophy into health care. This relates to three most important issues - patient integrity protection, complaint pathway definitions, and no-fault procedures. All of these were critical points which the Ombudsman often stressed in his yearly reports. About half of all complaints that are filed at the Ombudsman's office were related to health care.

The Act discusses the following rights of patients:

  1. the right to access to health care and to have preventive services ensured
  2. the right to equal access and treatment in health care
  3. the right to free choice of physicians and health care providers
  4. the right to a suitable, quality and safe health care
  5. the right to have patient's time respected
  6. the right to being informed and to participate
  7. the right to independently decide on own treatment
  8. the right to have the advance will respected
  9. special determination of rights of those patients, who are not capable of taking decisions about themselves by themselves
  10. the right to obtain a second opinion
  11. the right to be informed about the entire medical documentation set
  12. the right to have privacy respected and the right to personal data protection
  13. the right to have breeches of patient rights discussed and upgraded ...
  14. the right to have breeches of patient rights decided upon
  15. the right to free help and assistance in the execution of patient rights

Finally, a detailed process at different levels was elaborated to facilitate a multi-level adapted complaints' procedure.

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Characteristics of this policy

Degree of Innovation traditional rather innovative innovative
Degree of Controversy consensual consensual highly controversial
Structural or Systemic Impact marginal rather fundamental fundamental
Public Visibility very low very high very high
Transferability strongly system-dependent rather system-neutral system-neutral
current current   previous previous

Purpose and process analysis

Current Process Stages

Idea Pilot Policy Paper Legislation Implementation Evaluation Change
Implemented in this survey? no no no yes yes no no

Initiators of idea/main actors

  • Government

Stakeholder positions

There was a high level of consensus regarding this act which facilitated both its adoption and its implementation. The basic ideas of the new Patient Rights' Act (PRA) have been implemented. An important outstanding piece of legislation is the Health Records' Act which needs to be adapted according to the Patient Rights' Act. On the other hand, there was the direct application of the requirements of this act, particularly with the patient's right to have his/her time respected, into the system to support the monitoring of waiting lists. Overall, there was a high level of agreement over the positive aspects of the new PRA, especially in view of the most important rights with which it empowers patients.

Actors and positions

Description of actors and their positions
Government
Patient organisationsvery supportivevery supportive strongly opposed
Professional associationsvery supportivesupportive strongly opposed
Ombudsmanvery supportivevery supportive strongly opposed
current current   previous previous

Actors and influence

Description of actors and their influence

Government
Patient organisationsvery strongstrong none
Professional associationsvery strongstrong none
Ombudsmanvery strongvery strong none
current current   previous previous
Patient organisationsOmbudsmanProfessional associations

Positions and Influences at a glance

Graphical actors vs. influence map representing the above actors vs. influences table.

Adoption and implementation

Government - Ministry of Health - instituting regional representatives for patient rights' protection. The process was defined by the act. Previously patient rights were regulated only at the national level with little influence at lower administrative levels. The implementation at this level was carried out well and all regions now have regional representatives for patient rights' protection.

There were two other regulatory measures undertaken, which are prescribed by this act. One is the new complaints' procedure with health care providers and the other is the mediation procedure. The highest level of the complaints' procedure is the presentation of the case in front of a special national commission. This is reserved for those cases where the previous procedures - within the health care provider and through mediation - had failed.

 

Expected outcome

Impact of this policy

Quality of Health Care Services marginal neutral fundamental
Level of Equity system less equitable system more equitable system more equitable
Cost Efficiency very low neutral very high
current current   previous previous

References

Sources of Information

1. Patient Rights' Act (in Slovene). Official Gazette of the Republic of Slovenia 2008 Feb 11;43: 1045-1061. 

Reform formerly reported in

Patient Rights' Act
Process Stages: Legislation

Author/s and/or contributors to this survey

Tit Albreht

Suggested citation for this online article

Tit Albreht. "Implementation of the Patient Rights' Act". Health Policy Monitor, April 2010. Available at http://www.hpm.org/survey/si/a15/1