ARMEN HAYRAPETYAN, MD, PHD

NATIONAL TB CONTROL OFFICE

DIRECTOR

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3

4

TB OUT PATIENT

FACILITIES

21 TB OUT

PATIENT

FACILITIES IN

YEREVAN (CAPITAL)

51 TB OUT

PATIENT

FACILITIES

IN REGIONS

1. REPUBLICAN

TB DISPANSER

(RTBD)

2. YEREVAN

CITY TB

DISPANSER

(CTBD)

2 TB IN PATIENT UNITS (HOSPITAL

FOR DETAINEES AND IN-PATIENT

DEPARTMENT IN PRETRIAL DETENTION

FACILITIES) IN PENITENTIAL SYSTEM

MINISTRY OF HEALTH/NATIONAL TB PROGRAM

TB IN PATIENT

FACILITIES

7 IN-PATIENT

TB

DEPARTMENTS

IN REGIONAL

GENERAL

HOSPITALS

NATIONAL

REFERENCE

LABORATORY

29 MICROSCOPY

LABORATORIES

TB LABORATORIES

Reduce high level of hospitalization rate of TB patients (95%),

Improve TB hospital care quality,

Enhance outpatient TB services performance:

Increase TB case detection rate,

Increase TB treatment success rate,

Improve social support activities of TB patients

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State financing of the tuberculosis (TB) treatment and

care services in the Republic of Armenia (RA) is done

through the National Health Agency (NHA) of the MOH of

RA.

Services receiving financing are the following:

Out-patient (ambulatory) services

In-patient services

Sanatorium services

1. In-patient service financing: Base for the financing is the number of bed/days (load)

2. Out-patient service financing: In case of out-patient care financing done on per capita basis

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IN-PATIENT

AND

OUT-PATIENT

HEALTH CARE

CENTRES

HEALTH

STATE

AGENCY

REPORT

FINANCING

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0% 20% 40% 60% 80% 100%

Treatmentprocess

Diagnosis

Intensivephase

treatment

Expenses

70%

35%

5%

17%

30%

65%

95%

83%

In-patient Ambulatory

• Total state budget for TB service is about 4 million USD

• About 83% (3,4 millio USD)of them for in-

patient service

• Abour 17% (0,6 million USD) of them for out-patient service

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• Food packages for all TB patients

• Hygiene packages for all TB patients

• Training sessions on TB for all TB patients

• Transportation cost for all TB patients

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• Provide incentives for the primary health care (PHC) doctors based on the performance: Number of confirmed TB cases among suspects referred to the TB doctor from PHC

• Provide incentives for the TB doctors based on the performance:

Number of successfully treated patients

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• Whithin the “TB medical care services” program

plan separate financing mechanism for the TB

departments and dispensaries which include

provision of:

• Fixed costs of hospital maintenance

• Variable costs by the number of TB cases

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Year

Cost

Fixed Variable Total

% 76 % 24 % 100 %

• Decrease number of TB hospitalizations

• Optimization of the in-patient TB departments

(number of beds)

• Strengthen of the Primary Health Care service

• Early detection of the TB cases

• Early diagnosis of the TB cases

• Improved treatment outcomes

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Improved TB performance indicators for both, in-patient and out-patient TB services:

TB detection rate

TB treatment rate,

Quality improvement of TB in-patient and out-patient TB services,

Raising of satisfaction of patients and health care providers

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