System for healthcare in Serbia and importance of purchasing MRI device for children
System for healthcare in Serbia is organized in 3 levels: primary, secondary and tertiary. On primary level, healthcare services are given by healthcare hospitals and urgent medical services (and some other healthcare institutions, which are not important for MRI). On secondary level, healthcare is given by general and special hospitals, in which patients are hospitalized and this hospitals are providing specialist-advising services (ambulatory specialist examination). Tertiary healthcare institutions, which are representing the most complex and highly sophisticated healthcare institutions are Clinically-hospital centers, clinics and institutes.
Institute for Child and Youth Health Care of Vojvodina is the healthcare institution which is providing healthcare of tertiary level for kids from whole Vojvodina and secondary and tertiary healthcare for kids from Novi Sad, regarding the fact that Novi Sad doesn’t have generally hospital (secondary level of healthcare).
According to estimates of Republic institute for statistics of Serbia Republic for 2013 there are 3.581.647 citizens, 699.429 (19,52%) 0-19 years in Vojvodina. The Institute is giving tertiary healthcare for kids from the moment of birth until 18 year of their life, or for near 660.000 kids and adolescents in this age.
Institute consists of Clinic for children disease (226 beds), Clinic for children chirurgic (82 beds) and Clinic for children habilitation and rehabilitation (42 beds). During 2014 in Institute were hospitalized 13.111 kids and ambulance examined 138.484 kids. Within the Institute there is also the Department for radiology diagnostics, 4 doctors are currently working there as a radiology specialists, and 5 doctors are in a process of finishing their specialization. This department for one year is making 52.000 various radiology examination (RTG scanning, ultrasound examinations and computerized tomography).
Institute doesn’t have its own device for magnetic resonance. When it is needed to make MRI diagnostic, patients are redirected to Institute in Sremska Kamenica or in Clinical centre of Vojvodina. Weekly we are able to send 16 patients from our institution for MRI diagnostic (830 MRI diagnostics yearly). From our institution kids up to age of 7 are sent to MRI diagnostics (because they need to receive medics for sedation) and patients who are in bad health condition, patients who need urgent MRI diagnostics, regardless of their age. Patient is driven in special vehicle accompanied by doctor and nurse where he is receiving the sedation.
Children older than age of 7 and adolescents are making appointments for MRI diagnostic ambulant (around 1000 more patients yearly). Because of the occupancy of present MRI devices at Institute in Sremska Kamenica and in Clinical centre of Vojvodina, some kids are waiting even 18 months to get MRI diagnostic.
When Institute is not able to provide MRI diagnostic for some patient, then CT scan is made at our institution. It is necessary to have in mind that CT scan means exposing to ionizing radiation.
Expected positive effects of getting MRI device:
- Institute for Child and Youth Health Care of Vojvodina will be the only children healthcare institution on territory of Vojvodina which have magnet for MRI – overloading of other institutions which are making MRI diagnostics for our needs can be significantly reduced
- Period of waiting for MRI examination could be significantly shortened
- In some case MRI diagnostic can give much more information than CT diagnostic
- Transport with the presence of doctor, nurse and driver to other healthcare institution to make MRI diagnostic could be avoided, and complete diagnostic can be made in our Institution
- MRI diagnostic would be available 5 days in a week instead of 2 days in a week. And for emergency cases 365 days per year, 24 hours daily, that could confidently provide early diagnostic and medical treatment of seriously ill children.
It is estimated that in case that Institute for Child and Youth Health Care of Vojvodina have an MRI device, it would be possible to carry out about 4 000 diagnostics per year.
By purchasing the first specialized incubator with magnetic resonance for MRI diagnostics of premature babies and children would be the only institution in Serbia that could provide this kind of medical services, which will additionally improve quality of services we are currently providing.
Prof. dr Slobodan Grebeldinger
Director of Institute for Child and Youth Health Care of Vojvodina