Research Interests:
Research Interests:
Research Interests: Business, Decision Making, Evidence Based Practice, European Union, Health Technology, and 14 moreHealth Policy, Capacity Building, Medicine, Applied Economics, Romania, Humans, Romanian, Cost Sharing, Reimbursement, Public health systems and services research, Cost Control, Legislature, Directive, and Costs and Cost Analysis
Research Interests:
Background Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight,... more
Background Adolescents are exposed to various risks for their health: substance use, Internet overuse, video game addiction, unhealthy diet (reduced intake of fruits and vegetables, fast food culture), low physical activity, overweight, stress, violence, unsafe sexual behaviours, self-medication. Health literacy is defined as the knowledge, motivation and competence to access, understand, appraise and apply right information to make decisions in terms of healthcare, disease prevention and health promotion. Despite the advancement of theoretical models, many national and international health promotion programs, the percentage of unhealthy behaviours still persist in young age. Objective: Current review proposes to assess the implementation and effectiveness of various interventions in order to identify possible success or failure factors. Methods Comprehensive Systematic review was performed. After three steps data searching (in PubMed, SCOPUS, Cochrane, PsycINFO, Google Scholar) and...
Research Interests:
Introduction Stress, anxiety and depression symptoms are frequent in teenagers. Objectives: To identify the interventions effectively able to prevent or reduce anxiety, depression and psychological stress in adolescents; to assess the... more
Introduction Stress, anxiety and depression symptoms are frequent in teenagers. Objectives: To identify the interventions effectively able to prevent or reduce anxiety, depression and psychological stress in adolescents; to assess the effectiveness, feasibility and transferability of the interventions. Methods Comprehensive systematic review was performed. Three steps searching strategy using the databases: PsycINFO, PubMed, SCOPUS, Cochrane Library, and Google Scholar identified 679 studies and reviews. Critical appraisal was performed by 2 reviewers, data extraction performed on finally selected 59 reviews, RCT, cohort studies focused on sample size, geographical context, setting, description of intervention, measures of primary and secondary outcomes. Results The considered interventions are: Internet-based multifaceted cognitive bias modification training (CBM), Internet (iCBT) or school-based cognitive behavioral group training (CBT), Social skills training (SST), Metacognitive...
Research Interests:
Research Interests:
Research Interests:
Aim: On 2014 the Government of Romania has committed to improving health and health system through the implementation of the 2014–2020 National Health Strategy: Health for Prosperity. An official evaluation of the strategy implementation... more
Aim: On 2014 the Government of Romania has committed to improving health and health system through the implementation of the 2014–2020 National Health Strategy: Health for Prosperity. An official evaluation of the strategy implementation is not publicly available yet. This paper aims to provide an overview of the main incremental reforms taken during this period in Romania and to analyse the results from the perspective of the main Strategy goals. Methods: Information was collected from legislative documents, statistical and scientific publications. The main implemented or initiated incremental reforms, during the assessed period, were assigned to five main clusters: ”governance”, “resources for health”, “coverage and access”, “organization of health care”, “quality of care” and were analysed in accordance with the aim, the type, the implementation stage and the corresponding objectives of the Strategy. Results: The 2014–2020 National Health Strategy has definitely not reached all i...
Research Interests:
Lucrarea prezintă o incursiune în dezvoltarea instituţională a Şcolii Naţionale de Sănătate Publică, Management şi Perfecţionare în Domeniul Sanitar Bucureşti, înfiinţată în 1991, sub denumirea de Institutul Naţional pentru Servicii de... more
Lucrarea prezintă o incursiune în dezvoltarea instituţională a Şcolii Naţionale de Sănătate Publică, Management şi Perfecţionare în Domeniul Sanitar Bucureşti, înfiinţată în 1991, sub denumirea de Institutul Naţional pentru Servicii de Sănătate şi Conducere. Prezentarea este structurată pe cele trei mari tipuri de activităţi derulate de Şcoală: formare, asistenţă tehnică, cercetare. Toate activităţile Şcolii au fost iniţiate prin intermediul unor proiecte care s-au dovedit a fi sustenabile. Proiectul formării de manageri pentru sistemul de sănătate a fost finanţat de Banca Mondială între 1991-1998. Acesta a pus bazele programelor de formare, dezvoltate ulterior de Şcoală. ProIectul finanţării spitalelor în conformitate cu activitatea prestată, finanţat de USAID între 1997-2002, s-a concretizat în introducerea sistemului DRG ca mecanism de finanţare a spitalelor. Şcoala a preluat atribuţiile de colectare şi validare a datelor, în prezent colectând date de la un număr de 594 de spital...
Research Interests:
Background Solidarity is crucial for shifting from centralized to social health insurance model. Uninsured receive at least emergency and basic services free-of-charge. To which extent this policy really covers their health and services... more
Background Solidarity is crucial for shifting from centralized to social health insurance model. Uninsured receive at least emergency and basic services free-of-charge. To which extent this policy really covers their health and services needs remains to be assessed. Methods DRGNational database (457 hospitals) was interrogated for continuous hospitalization of uninsured, 2014-2018. Use patterns were identified by episodes, LOS, diagnose, admission criterion. Avoidable admissions were assessed according to OECD criteria. Results Number of hospital episodes in uninsured varied annually, difference ranging from -13.5 to 6.3%; largest decrease in 2015 possibly due to day surgery implemented in 2014. About 2.5-3% of all episodes and hospitalization days were for uninsured. Use patterns identified: Most common admission criterion: Emergencies (95%) compared to Specific diagnosis&treatment, Births, Potentially endemic/epidemic diseases; Most frequent diagnosis: Emergency around birth,Menta...
Research Interests:
Research Interests:
The trigger that set Romania on the path to health reform was the political change that took place in December 1989. The main legacies of the health system from the communist period were underfinancing, a rigid hierarchical command and... more
The trigger that set Romania on the path to health reform was the political change that took place in December 1989. The main legacies of the health system from the communist period were underfinancing, a rigid hierarchical command and control structure, a demotivated workforce, growing inequity, and the poor health status of the population. No matter how much pressure these factors put on the system, the changes that took place would not have been possible in the absence of general societal change.
Research Interests:
Şcoala Naţională de Sănătate Publică, Management si Perfecţionare in Domeniul Sanitar Bucuresti Catedra de Sănătate Publică si Management, Universitatea de Medicină si Farmacie Timisoara
Research Interests:
Research Interests:
To raise awareness about health inequalities, a well-functioning health inequality monitoring system (HIMS) is crucial. Drawing on work conducted under the Joint Action Health Equity Europe, the aim of this paper is to illustrate the... more
To raise awareness about health inequalities, a well-functioning health inequality monitoring system (HIMS) is crucial. Drawing on work conducted under the Joint Action Health Equity Europe, the aim of this paper is to illustrate the strengths and weaknesses in current health inequality monitoring based on lessons learned from 12 European countries and to discuss what can be done to strengthen their capacities. Fifty-five statements were used to collect information about the status of the capacities at different steps of the monitoring process. The results indicate that the preconditions for monitoring vary greatly between countries. The availability and quality of data are generally regarded as strong, as is the ability to disaggregate data by age and gender. Regarded as poorer is the ability to disaggregate data by socioeconomic factors, such as education and income, or by other measures of social position, such as ethnicity. Few countries have a proper health inequality monitorin...
Research Interests:
Aim: To document the contribution of the Public Health Cooperation in South Eastern Europe (PH-SEE) Project during 2000-2010, to the development of the New Public Health in SEE. Methods: Critical analysis of the project activities and... more
Aim: To document the contribution of the Public Health Cooperation in South Eastern Europe (PH-SEE) Project during 2000-2010, to the development of the New Public Health in SEE. Methods: Critical analysis of the project activities and outcomes based on the relevant documents, Internet sources and published literature, as well as personal experience and observations of the authors as active contributors to the PH-SEE Network activities. Facts and findings: Within the last 10 years South Eastern Europe (SEE) countries have been experiencing a kind of renaissance or revolution of public health in their region. There has been undergoing profound changes with raising awareness, capacity building in public health and health management, and preparing target-oriented public health practitioners, researchers, health policy analysts and managers for health care institutions. A strong network for long-term cooperation was established among public health institutions and professionals in the SE...
Currently, at national level, two representative actions could provide information for supporting policy making in the field of reproductive health, and these two public health actions need improvements in certain aspects: The... more
Currently, at national level, two representative actions could provide information for supporting policy making in the field of reproductive health, and these two public health actions need improvements in certain aspects: The Reproductive Health Study in Romania (RHS), and the National Health Programme for Mother and Child Health (NHP-MCH). After decades of sexual education and family planning interventions, reproductive health in Romania is still a matter of concern. The current image of this field in Romania is difficult to be precisely configured having few elements and data in this sense. Main available indicators highlight a low contraception use, a high rate of abortion and high birth rate among adolescents is mainly the consequence of insufficient information on contraception among all population strata. Implementation of an action towards the development of a health inequality monitoring system would be of great importance for getting timely information on this subject, and...
Mental health is considered a public health problem due to the following particularities of the mental diseases: high incidence and prevalence; long term duration, with consequences over family, social and professional life; cause severe... more
Mental health is considered a public health problem due to the following particularities of the mental diseases: high incidence and prevalence; long term duration, with consequences over family, social and professional life; cause severe disability; high cost imposed on individual, family and community; associated stigma and discrimination. The main determinants of mental health are: socio-economic, demographic and psychological factors. Public health can bring a major contribution to the improvement of mental health by its main functions, such as: needs evaluation, priority setting, policy development, health promotion and disease prevention, mental health services research and development. According to WHO recommendations, mental health services should be organized based on principles of accessibility, coordinated care, continuity of care, effectiveness, equity and respect for human rights. As well, mental health care should be provided through general health services and communit...
Research Interests:
Because there are no pure formal or informal organisations in real world, one may conclude that an organisation is a mix of formal and informal groups. Thus, its performance depends on the management ability to recognise the existence of... more
Because there are no pure formal or informal organisations in real world, one may conclude that an organisation is a mix of formal and informal groups. Thus, its performance depends on the management ability to recognise the existence of these groups, to transform them from groups into working teams, to motivate and stimulate them to achieve organisation's goals. We must differentiate the concept of group versus the concept of team. A simple definition of the group can be: two or more persons who come into contact for a purpose and who consider the contact meaningful. A team has to accomplish bigger goals than any individual group. The purpose of a team is to perform, achieve results and be successful in the organisation or marketplace. The literature describes several types of groups according to a set of criteria. Formal groups (work team) is created by an organisation in order to achieve a certain goal, being recognised and receiving full support from the organisation. Inform...
Research Interests:
Research Interests:
Currently, at national level, two representative actions could provide information for supporting policy making in the field of reproductive health, and these two public health actions need improvements in certain aspects: The... more
Currently, at national level, two representative actions could provide information for supporting policy making in the field of reproductive health, and these two public health actions need improvements in certain aspects: The Reproductive Health Study in Romania (RHS), and the National Health Programme for Mother and Child Health (NHP-MCH). After decades of sexual education and family planning interventions, reproductive health in Romania is still a matter of concern. The current image of this field in Romania is difficult to be precisely configured having few elements and data in this sense. Main available indicators highlight a low contraception use, a high rate of abortion and high birth rate among adolescents is mainly the consequence of insufficient information on contraception among all population strata. Implementation of an action towards the development of a health inequality monitoring system would be of great importance for getting timely information on this subject, and...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: English language, Political Science, Public Health, Health Policy, Adolescent, and 15 moreMedicine, European Public Health Policies, Albania, Humans, Europe, Organizations, Female, Feasibility Studies, Male, Adult, Public health systems and services research, English Language, Ministry of Health, Canadian International Development Agency, and Public health practice
Aim: Throughout 2004-2010, the series of 6 books entitled “Handbooks for Teachers, Researchers and Health Professionals” were published within the frame of the public health network established in South Eastern Europe (SEE), covering the... more
Aim: Throughout 2004-2010, the series of 6 books entitled “Handbooks for Teachers, Researchers and Health Professionals” were published within the frame of the public health network established in South Eastern Europe (SEE), covering the total of 249 teaching modules. The aim of the study was to assess the use and exchange of these modules between the authors. Methods: Out of 148 identified authors, 106 took part in the cross-sectional study carried out from July to November 2011 (response rate: 71.6%). The primary endpoints were the utilization (use and/or exchange) of the modules in general, the percentage of utilized modules from all volumes, the percentages of utilized modules of each volume separately, and the percentage of utilized modules from all the volumes at different levels of the educational process. Non-parametric statistical methods were used for analysis (e.g. Mann-Whitney and Friedman tests). Results: Module utilization was reported by 80/106 participants (75.5%). T...
Research Interests:
Aim: To document the contribution of the Public Health Cooperation in South Eastern Europe (PH-SEE) Project during 2000-2010, to the development of the New Public Health in SEE. Methods: Critical analysis of the project activities and... more
Aim: To document the contribution of the Public Health Cooperation in
South Eastern Europe (PH-SEE) Project during 2000-2010, to the development
of the New Public Health in SEE.
Methods: Critical analysis of the project activities and outcomes based on the
relevant documents, Internet sources and published literature, as well as personal
experience and observations of the authors as active contributors to the PH-SEE
Network activities.
Facts and findings: Within the last 10 years South Eastern Europe (SEE)
countries have been experiencing a kind of renaissance or revolution of public
health in their region. There has been undergoing profound changes with raising
awareness, capacity building in public health and health management, and
preparing target-oriented public health practitioners, researchers, health policy
analysts and managers for health care institutions. A strong network for longterm
cooperation was established among public health institutions and
professionals in the SEE region.
Advancements in the teaching and research in public health and analysis/
formulation of national health policies were followed by curriculum development
for Master in Public Health and establishment of Public Health postgraduate
education programmes/centres/schools of public health in almost each country in
the SEE region.
Among the most tangible outcomes of the Project were the handbooks for
teachers, researchers and public health professionals. Six volumes were published
so far, and the seventh one will be published next year, 2011.
Conclusion: The PH-SEE project has been a real success, not only in terms
of achieving its goals related to public health development in the region by raising
training and research capacity, but also in terms of inter-country cooperation,
getting in the line with the Stability Pact for South Eastern Europe main goal of
strengthening the efforts of the countries of the region in fostering peace,
democracy, respect for human rights and economic prosperity.
Key words: public health networking, Master in public health, public health
research, Forum for Public Health in South Eastern Europe
South Eastern Europe (PH-SEE) Project during 2000-2010, to the development
of the New Public Health in SEE.
Methods: Critical analysis of the project activities and outcomes based on the
relevant documents, Internet sources and published literature, as well as personal
experience and observations of the authors as active contributors to the PH-SEE
Network activities.
Facts and findings: Within the last 10 years South Eastern Europe (SEE)
countries have been experiencing a kind of renaissance or revolution of public
health in their region. There has been undergoing profound changes with raising
awareness, capacity building in public health and health management, and
preparing target-oriented public health practitioners, researchers, health policy
analysts and managers for health care institutions. A strong network for longterm
cooperation was established among public health institutions and
professionals in the SEE region.
Advancements in the teaching and research in public health and analysis/
formulation of national health policies were followed by curriculum development
for Master in Public Health and establishment of Public Health postgraduate
education programmes/centres/schools of public health in almost each country in
the SEE region.
Among the most tangible outcomes of the Project were the handbooks for
teachers, researchers and public health professionals. Six volumes were published
so far, and the seventh one will be published next year, 2011.
Conclusion: The PH-SEE project has been a real success, not only in terms
of achieving its goals related to public health development in the region by raising
training and research capacity, but also in terms of inter-country cooperation,
getting in the line with the Stability Pact for South Eastern Europe main goal of
strengthening the efforts of the countries of the region in fostering peace,
democracy, respect for human rights and economic prosperity.
Key words: public health networking, Master in public health, public health
research, Forum for Public Health in South Eastern Europe
Research Interests:
This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social... more
This analysis of the Romanian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Romanian health care system is a social health insurance system that has remained highly centralized despite recent efforts to decentralize some regulatory functions. It provides a comprehensive benefits package to the 85% of the population that is covered, with the remaining population having access to a minimum package of benefits. While every insured person has access to the same health care benefits regardless of their socioeconomic situation, there are inequities in access to health care across many dimensions, such as rural versus urban, and health outcomes also differ across these dimensions. The Romanian population has seen increasing life expectancy and declining mortality rates but both remain among the worst in the European Union. Some unfavourable trends have been observed, inclu...
Research Interests:
An increasing number of EU States are using the Health Technology Assessment (HTA) approach, and as health technologies, pharmaceuticals are one of the main fields of application in HTA. This is a review aiming to identify the current... more
An increasing number of EU States are using the Health Technology Assessment (HTA) approach, and as health technologies, pharmaceuticals are one of the main fields of application in HTA. This is a review aiming to identify the current status of the HTA collaboration efforts in EU and in Romania, taking into consideration the growing role of HTA in decisions about the level of price and reimbursement in some EU countries or, in other countries, in decision on whether to reimburse a new product or to reject its funding totally. Romanian HTA system needs further development, both in terms of financial resources and, probably more important, human resources; the efforts in the long run will bring great returns to the entire health system, allowing better, safer, and more efficient use of pharmaceuticals and other health technologies. The scientific evidence provided may support the decision-making process.
Research Interests:
Research Interests:
One of the main objectives of the National Strategy for Hospitals Rationalization approved by the Romanian Government in 2011 was to resize the hospital sector in order to improve efficiency. To this end, the government decided the... more
One of the main objectives of the National Strategy for Hospitals Rationalization approved by the Romanian Government in 2011 was to resize the hospital sector in order to improve efficiency. To this end, the government decided the closure of 67 inpatient care facilities with low efficiency scores, giving them the opportunity to become nursing homes for elderly under a national programme financed by the Ministry of Labour, Family and Social Protection. The measure faced a tremendous public opposition that put pressure on politicians to re-open some hospitals, while other hospitals were re-opened by the governments that followed in order to consolidate their power. Since only 20 closed institutions have been reorganized as nursing homes for elderly and almost 40 are currently performing medical activities, this decision was generally perceived as a policy failure. Nevertheless, a thorough analysis, shows that the medical facilities that are still functioning - either merged with othe...
Research Interests:
The Presidential Commission for Romanian Public Health Policies Analysis and Development established in 2007 by the President of Romania has performed an analysis of the population health status and the health system in the view of making... more
The Presidential Commission for Romanian Public Health Policies Analysis and Development established in 2007 by the President of Romania has performed an analysis of the population health status and the health system in the view of making policy recommendations for the improvement of health system performance. The driving forces that lead to the need for change are: the poor health status of the population, the discontent of both health workers and the population, and the low rating of health system performance, as they are revealed in the international statistics. The Commission has identified 6 major intervention areas in order to address the dysfunctions of the health system: health system financing, health system organization, hospital care, drug policy, primary care, and human resources. The dysfunctions identified within the 6 areas lead to the violation of one of the most elementary patient rights: the right to quality care and medical treatment in accordance to their needs, ...
Because there are no pure formal or informal organisations in real world, one may conclude that an organisation is a mix of formal and informal groups. Thus, its performance depends on the management ability to recognise the existence of... more
Because there are no pure formal or informal organisations in real world, one may conclude that an organisation is a mix of formal and informal groups. Thus, its performance depends on the management ability to recognise the existence of these groups, to transform them from groups into working teams, to motivate and stimulate them to achieve organisations goals. We must differentiate the concept of group versus the concept of team. A simple definition of the group can be: two or more persons who come into contact for a purpose and who consider the contact meaningful. A team has to accomplish bigger goals than any individual group. The purpose of a team is to perform, achieve results and be successful in the organisation or marketplace. The literature describes several types of groups according to a set of criteria. Formal groups (work team) is created by an organisation in order to achieve a certain goal, being recognised and receiving full support from the organisation. Informal g...
Research Interests: English language, Sustainable Development, Public Health, Health Policy, Adolescent, and 16 moreEuropean Public Health Policies, Albania, Humans, Europe, South Eastern Europe, Organizations, Female, Feasibility Studies, Male, Transition Countries, Adult, Public health systems and services research, World Health Organization, Mental health public policy & practice, English Language, and Ministry of Health
Research Interests:
The aim of the paper is to examine the health financing reform in Romania in order to find out to what extent the expected results were achieved, what were the main factors that influenced the reform process and in what way the main... more
The aim of the paper is to examine the health financing reform in Romania in order to find out to what extent the expected results were achieved, what were the main factors that influenced the reform process and in what way the main unsolved problems are to be sorted out. The paper describes the main features of the health financing reform outlining the factors that determined or influenced it, presents some of the reform outcomes and discusses the current health policy agenda. The main findings of this examination are the following: the expected results of the health care reform were not fully achieved (one of the main causes was the too high expectations that did not take into account the country’s low starting point at the beginning of the transition); the reform process was slowed down mainly by political instability, the funds for health increased over time, but this was not enough to increase health system performance and patient satisfaction, the health system reform finally became one of the main priorities on the government agenda. The paper concludes that it took quite a long time until the Romanian government took over its stewardship role of the health system, with the understanding that health reform cannot be a separate process but rather is in need of intersectorial action, clear and coherent legislative support and strong political backing.