A NEW CENTER FOR CARDIOLOGY AND CARDIAC SURGERY IN TUZLA
J. Bergsland, E. Mujanović, S. Jahić, M. Merić, E. Kabil and
Clinic, University Clinical Center Tuzla, Bosnia and Herzegovina
Objective: Prior to national independence there
was no center for advanced treatment of cardiovascular disease
in Bosnia. A high percentage of the health care budget of the
republic was used to pay for such services in other republics
and abroad. The purpose of this paper is to describe the methods
used to develop a modern, national treatment canter in Tuzla.
Methods: The war of aggression against Bosnia forced the health
care personnel to re-evaluate the organisation. At the end of
war heart disease soon reemerged as the major cause of mortality
and morbidity. An effort was started in Tuzla to develop a modern
center based on new principles.
a) An exchange program was started to educate
health care personnel locally and international centers.
b) An intensive English language program was started
to facilitate communication and make modern teaching material
available to the team
c) The Tuzla medical leadership encouraged a reorganisation
and decentralisation of decision-making processes.
d) Extensive travel and consultation programs
were conducted through a grant program supported by USAID.
e) Building upgrades and equipment purchases
were accomplished by international and local funding.
f) International supervisor was established with
clear goal that the local team would be self-sufficient in a short
g) Corporation with the University was established
to initiate and research efforts.
h) The insurance funds took an active role in
establishing modern reimbursement policies.
Results: The Tuzla cardiac program is presently
very active. All modern therapies for coronary artery valvular
disease are established. A center for pacing and electrophysiology
will be opened this year. The academic program is being established
and will bring new resources and programs to Bosnia. Huge savings
for the society in the form of spared lives and finances are being
realised. Conclusion: We believe that a partially independent
Center model had shown great promise in the Tuzla Cardiovascular
Center. We believe that this model can be applied to most tertiary
care services in the country. The medical care system in Bosnia
must be based on financial independence and responsibility, excellent
quality of care and freedom of choice for the population. We believe
that the cardiovascular center in Tuzla can serve as a model to
accomplish such goals.