Avtor/Urednik		Karapandža, Jurij
Naslov		Težave na primarni ravni pri oskrbi z ustreznimi ortozami in medicinskimi pripomočki za gibanje
Prevedeni naslov		Appropriate orthoses and mobility aids at the primary level of health care
Tip		članek
Vir		In: 100 let ortopedske tehnike v Sloveniji ter rehabilitacijska tehnologija danes : zbornik predavanj : proceedings Ljubljana : Univerzitetni rehabilitacijski inštitut Republike Slovenije - Soča
Vol. in št.		Letnik 18, št. supl. 1
Leto izdaje		2019
Obseg		str. 79-84
Jezik		slv
Abstrakt		Učinkoviti zdravstveni sistemi skušajo zagotoviti ustrezen delež storitev na primerni ravni, kar velja tudi za oskrbo z medicinskimi pripomočki. V tem segmentu jasne meje med primarno in sekundarno ravnijo zdravstvene oskrbe ni možno postaviti. Na področju oskrbe z medicinskimi pripomočki je v bilo na primarni ravni v letu 2017 predpisanih 21 % vseh ortoz, med katerimi so v večini primerov le tri ortoze: ojačan križni pas, peronealna ortoza in ortoza za gleženj. Med vzroki za tako omejeno predpisovanje avtor izpostavlja nekaj možnih razlogov: preozko postavljena medicinska merila, pomanjkljiv Seznam medicinskih pripomočkov, pomanjkanje pooblastil specialistom za predpis pripomočkov z manjšimi prilagoditvami in enostavnih individualno izdelanih ortoz, nizki cenovni standardi, nejasno definiran standard "najcenejši še funkcionalno ustrezen pripomoček" ter premalo strokovno usposobljenih inženirjev ortotike na primarni ravni in pri dobaviteljih medicinskih pripomočkov. Za izdelavo posebej izdelanih čevljev dobi izvajalec pogosto pomanjkljiva navodila o lastnostih in korekcijah, ki jih mora čevelj zagotavljati; ob tem se postavlja vprašanje, ali so vsi "ustrezni" specialisti resnično usposobljeni za predpis ortopedske obutve. Pri vozičkih avtor izpostavlja zelo nizek odstotek predpisovanja vozičkov na elektromotorni pogoni na primarni in sekundarni ravni ter težave, ki so posledica omejitve pooblastil za predpis serijsko izdelanega počivalnika le specialistom, določenim s sklepom ZZZS, ki jih na primarni ravni ni.Efficient health care systems aim to provide a suitable amount of services at the primary level, including provision of orthoses and mobility aids. But it is often difficult to draw a distinct line between the primary and the secondary level of health care. Twenty-one per cent of orthoses were prescribed at the primary level in Slovenia in 2017. The majority of those orthoses were of only three types: lower-back braces, peroneal orthosis and ankle orthosis. In the author's view, such limited prescription of orthoses could be attributed to narrowly defined medical criteria, incomplete List of Medical Devices, the fact that specialists are not authorised to prescribe medical aids with slight alterations for individual needs or simple individually-designed orthoses, low price standards, unclearly defined standard "the cheapest appropriate medical aid that is still functional", and the shortage of certified orthotists at the primary health care level as well as among orthotics suppliers. The instructions that are given to manufacturers of individually designed orthopaedic shoes by medical specialists often lack specific information on characteristics and corrections that the orthopaedic shoes should have. That raises the question whether all the designated specialists are sufficiently qualified for prescribing appropriate orthopaedic shoes. The author also points out that the rate of prescribed powered wheelchairs is very low at the primary level. Another difficulty that the patients face is that tilting wheelchairs can be prescribed only by a few specialists who have been given special authorisation by the Health Insurance Institute of Slovenia, and none of them works at the primary health care level.
Deskriptorji		Orthotic Devices
Proste vsebinske oznake		ortoze predpisovanje ortoz medicinski pripomočki za gibanje ortopedski čevlji primarno zdravstvo othroses orthotic prescription mobility aids orthopedic shoes primary level