Academy of Medical Sciences of Croatia
WHITE PAPER Croatian Society of Gastroenterology Consensus October 2019
2020
Croatian
Jedan od ključnih elemenata zdravstvene zaštite nedvojbeno je dostupnost. Imati jednaku zdravstvenu zaštitu i mogućnost ostvarenja najviše razine zdravstvene usluge temeljno je pravo svakog pojedinca. To pravo nije samo humano i etički neosporno, nego je i defi nirano zakonom. U tom smislu jasno je da pravo na zdravstvenu zaštitu ne smije biti privilegija već imperativ postupanja. Znanjem, entuzijazmom i dobrom organizacijom, čak i u materijalno ograničenim okolnostima, može se postići vrlo mnogo. Republika Hrvatska je zemlja posebnih geografskih obilježja i koliko je to čini lijepom u svoj njenoj raznolikosti toliko nerijetko otežava dostupnost najkvalitetnijim oblicima zdravstvene zaštite i zdravstvenih postupaka. Formiranjem visoko specijaliziranih centara objedinjenih u dobro organiziranu mrežu i uz organiziranu i koordiniranu komunikaciju zdravstvenih djelatnika, svim bolesnicima sa specifi čnom i zahtjevnom problematikom može biti pružena najbolja zdravstvena zaštita. U gastroenterologiji akutni kolangitis, akutni bilijarni pankreatitis i komplikacije kolecistektomije u obliku postoperacijskih ozljeda žučovoda, dijagnoze su koje zahtijevaju postupak endoskopske retrogradne kolangiopankreatografi je (ERCP) unutar 72 sata, a u pojedinim slučajevima i unutar 24 sata. Nažalost, činjenica je da trenutno u Republici Hrvatskoj takvi bolesnici nerijetko čekaju na intervenciju znatno duže jer ne postoji organizirana mreža slanja i prihvata spomenute kategorije bolesnika. Radna skupina Hrvatskog gastroenterološkog društva izradila je predložak “Hrvatske mreže intervencijske gastroenterologije – ERCP” i nakon široke javne rasprave Skupština Društva prihvatila je spomenuti dokument kao konsenzus Hrvatskog gastroenterološkog društva. Implementacijom navedenog konsenzusa u svakodnevnu kliničku praksu osigurava se ostvarivanje prava svih građana Republike Hrvatske na jednaku dostupnost najbolje zdravstvene zaštite, očuvanje i poboljšanje zdravlja uz dulji i kvalitetniji život velikog broja ovih bolesnika. Mreža CRO-GASTRONET-ERCP osmišljena je i s nakanom da se svim zdravstvenim djelatnicima, u svim zdravstvenim ustanovama Republike Hrvatske olakša brza komunikacija s devet visoko specijaliziranih tercijarnih centara za djelatnost ERCP-a sa ciljem uske suradnje u smislu najboljeg i najbržeg mogućeg liječenja bolesnika s dijagnozama akutnog kolangitisa, akutnog bilijarnog pankreatitisa ili komplikacija kolecistektomije u obliku postoperacijskih ozljeda žučovoda. Jasno defi niranim postupnicima omogućit će se standardizacija zdravstvenih usluga u korist bolesnika, ali i najučinkovitije korištenje ekonomskih resursa. Svaki početak je težak, ali se kako predvidive tako i nepredvidive prepreke mogu uspješno riješiti zajedničkim konstruktivnim radom i naporima svih dionika zdravstvenog sustava.Availability is undoubtedly one of the key elements of the healthcare system. Th e fundamental right of every person is to have the highest level of healthcare service based on excellence and equality. Th is right is indisputable not only from the human and ethical viewpoint, but is also defined by law. In this regard, it is clear that the right to healthcare service must not be merely a privilege but rather an imperative. A great deal can be achieved with knowledge, enthusiasm and good organization, even under circumstances of material restrictions. Republic of Croatia is a country of specific geographical features, which makes it beautiful in all its diversity but oft en makes the availability of specialized forms of healthcare service and procedures difficult. By forming highly specialized centers integrated into a well-organized network and with organized and coordinated communication of healthcare professionals, all patients with specifi c and demanding problems can be provided with the best healthcare service. In gastroenterology, acute cholangitis, acute biliary pancreatitis and cholecystectomy complications in terms of postoperative bile duct injuries are diagnoses requiring endoscopic retrograde cholangiopancreatography (ERCP) within 72 hours, and in some cases within 24 hours. Unfortunately, the fact is that currently in the Republic of Croatia, such patients oft en have to wait for intervention considerably longer because there is no organized network of referring and admitting this category of patients. A working group of the Croatian Society of Gastroenterology has developed a model for the Croatian Interventional Gastroenterology Network-ERCP and, following a broad public discussion, the Assembly of the Society accepted the document as a consensus of the Croatian Society of Gastroenterology. Th e implementation of this consensus into everyday clinical practice provides for exercising the rights of all citizens of the Republic of Croatia to equal availability of the best healthcare service, and for preservation and improvement of health with longer and better quality life for a large number of these patients. Th e CRO-GASTRONET-ERCP has also been designed to facilitate all healthcare professionals at all healthcare institutions in the Republic of Croatia fast communication with nine highly specialized tertiary centers for ERCP, with the aim of achieving close cooperation in providing the best and fastest possible treatment of patients with the diagnoses of acute cholangitis, acute biliary pancreatitis or cholecystectomy complications in terms of postoperative bile duct injuries. Clearly defined protocols will make it possible to standardize healthcare services to the benefit of patients, but also to use economic resources most efficiently. Every beginning is hard, but both foreseeable and unforeseeable obstacles can be resolved successfully with joint constructive action and efforts of all stakeholders of the healthcare system
Partneri
Pretplatite se na repozitorijum