The structure of the sending system
The protection of patients’ rights holds significant importance in the modern healthcare system, especially the possibility of free choice of physician. This right ensures that patients can choose their doctors and the location of treatment at their discretion. However, it is important to note that free choice of physician is not unlimited, as various regulations, such as the referral requirement, influence the options available.
The conditions for accessing different healthcare services may vary, and patients should be aware of the options available to them. Understanding the right to choose a physician can help patients navigate healthcare services more effectively and ensure they receive the most appropriate care.
The role of referrals is crucial during medical treatments, as they determine when and where patients can access necessary treatments. Understanding access to various healthcare services contributes to patients’ awareness and the quality of care.
Options for Healthcare Services Without Referrals
In emergency healthcare situations, patients do not need a referral and can access services at any time. This provision is extremely important, as urgent situations require prompt and appropriate medical assistance. Within primary care, services are also available through general practitioners, which patients can access with their chosen doctor. If a patient cannot visit their chosen general practitioner, they can turn to the general practitioner responsible for their area, facilitating seamless care.
Generally, a referral is required for accessing outpatient specialist care, which is issued by the general practitioner. However, there are exceptions; for instance, in urgent cases, a referral may be waived. Inpatient care is also tied to referrals, but there is also the possibility of receiving care without a referral in emergency situations. It is important to emphasize that for non-emergency services, the referral must direct the patient to the nearest healthcare providers in their residential area, and services in other areas can only be accessed with the appropriate health insurance fund’s contribution.
The Functioning of the Referral System
The purpose of the referral system is to ensure that patients receive appropriate healthcare. Many outpatient specialist services, such as dermatology, gynecology, psychiatry, and other fields, are available without referrals, but they require prior appointment requests. To facilitate access to medical care, patients may also visit other specialist areas without a referral if the care is urgent and, in the judgment of the doctors, immediate intervention is necessary.
Referrals are valid for 90 days, and patients must seek the prescribed specialist care within this time frame. It is important to know that healthcare providers obligated to provide territorial care cannot deny care. Furthermore, if a patient chooses an institution that is not obligated to provide territorial care, the referring physician must provide a written statement indicating whether the institution will accept the patient.
The appropriate healthcare institution must inform the referring physician in writing within 48 hours of being contacted whether it can accept the patient. Institutions may only deny care if it jeopardizes the fulfillment of their territorial obligations.
Healthcare Providers Offering Outpatient Care
The national chief medical officer is responsible for maintaining the registry of healthcare institutions providing outpatient care. Patients can request to be referred to institutions that are not obligated to provide territorial care, provided that the chosen institution confirms in writing that it can accept the patient. This option expands patients’ choices and ensures they receive the most appropriate treatment.
The transparency and functioning of the referral system assist patients in effectively accessing the necessary medical care while considering territorial obligations and the capacity of healthcare providers. The protection of patients’ rights and proper information during the use of healthcare services are essential for a smooth recovery process.
