Sağlık Politikaları Çalışma Grubu

Tüberküloz ve Nontüberküloz Personelinin Ödemeleri Hakkında SPÇG Öneri Raporu

Tüberküloz hastalarının çok büyük bir kısmı, derneğimiz üyelerinin çalıştığı göğüs hastalıkları hastanelerinde görev yapmaktadırlar. Bu hastanelere ülkemizdeki tüm kuruluş ve hastanelerden tüberküloz düşünülen ya da tüberküloz tanısı alan hastalar sevk edilmektedir. Ayrıca solunum sistemi yakınmaları nedeniyle göğüs hastalıkları hastanelerine başvuran hastaların bir kısmında tüberküloz teşhisi konulmaktadır. Bazı tüberküloz hastalarının başvuru yakınma ve klinik verileri başlangıçta tüberkülozu düşündürmeyebilmektedir.  Ayırıcı tanı yapılan ve çeşitli ön tanılar ile incelenen hastalarda tüberküloz saptanabilmektedir. Bu hastalara tanı alana kadar geçen sürelerde hastalığın bulaşmasına neden olacak çeşitli girişimsel işlemler yapıldığı gibi, tanı koyma aşamasında ve tedaviye başlanılana kadar geçen süre içerisinde tüm göğüs hastaları ile aynı servislerde takip edilmek durumundadırlar. Tanısı konulan hastalara hızla tedavi başlanarak triyaj uygulanmakta ve bu hastaların takiplerin yapıldığı servislere nakil edilmektedirler. Naklin yapıldığı ve tedavinin bir kısmının devam edildiği servisler geleneksel olarak tüberküloz servisi olarak anılmaktadırlar. Hastaların ilk başvurduğu göğüs hastalıkları klinikleri ise yine geleneksel olarak non-tüberküloz servisleri olarak anılmaktadırlar. Her ne kadar non-tüberküloz servisi olarak adlandırılsalar bile, bu bölümde her zaman yatabilecek hastalar arasından yukarıda da belirtildiği gibi tüberküloz tanısı konulabilmektedir. Tanıya ve tedavinin başlanmasına kadar geçen süre boyunca,  bu servislerde ve tanısal işlem ve laboratuar hizmetlerin yapıldığı birimlerde çalışan personel gerek hastalar ile direkt temas, bronkoskopi gibi girişimsel işlemler esnasında ve gerekse de hastalara ait balgam, doku gibi materyallerin incelenmesi sırasında hastalık riskine maruz kalmaktadırlar.

 

12/5/2006 tarihli ve 26166 sayılı Resmi Gazetede yayımlanarak yürürlüğe giren “Sağlık Bakanlığına Bağlı Sağlık Kurum ve Kuruluşlarında Görevli Personele Döner Sermaye Gelirlerinden Ek Ödeme Yapılmasına Dair Yönetmenlik” in 5 inci maddesinin 1 inci fıkrasının (y) bendinde “Kurumlarda özellik arz eden birimler; ameliyathane, yoğun bakım, doğumhane, yenidoğan, süt çocuğu, yanık, diyaliz, acil servis-poliklinik, kapalı psikiyatri servisleri, AMATEM, organ ve doku nakli ve kemik iliği nakil üniteleridir. Ayrıca yüksek bulaştırıcılığı olan ve izolasyon gerektiren hastalara hizmet veren personele hizmet ettiği sürece özellik arz eden birimler için öngörülen katsayılar üzerinden ek ödeme yapılır” hükmü bulunmaktadır. Ayrıca söz konusu yönetmenliğin uygulanmasına dair, 11/8/2010 tarih ve 2010/57 sayılı tedavi hizmetleri Genel Müdürlüğünün genelgesine göre, “İlgili kurumda, standart önlemler dışında solunum, damlacık, temas izolasyonu gerektiren Kırım Kongo Ateşi, H1N1, SARS, Kuş gribi, menengekoksik menengit gibi tanıları bulunan hastalara hastalıkları süresince sağlık hizmeti verildiği klinik veya birimlerde çalışan ve bu hastalara hizmet veren personele, bu hastalara hizmet verdikleri süre boyunca özellikli birim ve katsayıları üzerinden ek ödeme yapılacağı hükmü, gereği “ tüberküloz servisinde görev yapan personelin mezkür Yönetmenlik ve Genelge hükümleri uyarınca izolasyonu gereken hastalara hizmet verdiği sürece ek ödemesinin özellik arz eden birimler için öngörülen katsayılar üzerinden hesaplanması gerektiği yolunda bir mütalaa bulunmaktadır.

Söz konusu mütalaa sonucuna dayanılarak, ilgili hastanelerde sadece tüberküloz kliniği olarak adlandırılan kliniklerde çalışan sağlık personeline ek ödeme yapılması, hastalık riskinin bulunduğu klinik, laboratuar ve birimlerde çalışan personele yapılmaması,  yukarıda bahsedilen yönetmenlik ve resmi yazıların ruhu ile çelişmektedir. Ayrıca bu tür bir düzenleme hakkaniyet ilkelerine de aykırı olup, risk altındaki personel arasında ayrımcık ve eşitsizliğe neden olmaktadır.

Derneğimiz üyelerinin çoğunlukta bulunduğu hastanelerde çalışan ve uzmanlık alanımızı ilgilendiren tüberküloz hastalığının teşhis ve tedavisinde sorumlu olan birimlerde çalışan ve bir kısmı da derneğimiz üyesi olan hekim dışı sağlık personelinin de ek ödeme alınması gerektiğine inanmaktayız. Bu konuda ortaya çıkan adaletsiz durumun düzeltilmesi için gereğinin yapılması dileğiyle.

TTD SPÇG YK

suprax 400 mg 5 tablet

suprax 100 60 ml suprax 100 mg 50 ml suspansiyon where to buy suprax

suprax 400 mg 5 tablet

suprax 100 60 ml http://www.dunshaughlinac.com/news-details.asp?id=112 where to buy suprax

suprax 400 mg 5 tablet

suprax 100 60 ml suprax dt 400 mg disperse olabilen 5 tablet where to buy suprax

suprax 400 mg 5 tablet

suprax 100 60 ml suprax dt 400 mg disperse olabilen 5 tablet where to buy suprax

suprax 400 mg 5 tablet

suprax 100 60 ml suprax dt 400 mg disperse olabilen 5 tablet where to buy suprax

800 gambler

350,000 problem gamblers women and gambling: symptoms and effects 1-800-gambler®

800 gambler

350,000 problem gamblers women and gambling: symptoms and effects 1-800-gambler®

800 gambler

350,000 problem gamblers new jersey council on compulsive gambling 1-800-gambler®

800 gambler

350,000 problem gamblers council on compulsive gambling of new jersey problem gambling 1-800-gambler®

800 gambler

350,000 problem gamblers http://www.800gambler.org/ 1-800-gambler®

order biaxin 250mg

ordering clarithromycin http://www.geospatialworld.net/Event/View.aspx?EID=53 buy clarithromycin 250mg

order biaxin 250mg

ordering clarithromycin buy clarithromycin buy clarithromycin 250mg

order biaxin 250mg

ordering clarithromycin http://www.geospatialworld.net/Event/View.aspx?EID=53 buy clarithromycin 250mg

order biaxin 250mg

ordering clarithromycin buy clarithromycin pills buy clarithromycin 250mg

order biaxin 250mg

ordering clarithromycin biaxin online buy clarithromycin 250mg

purchasing biaxin

buy generic clarithromycin http://www.geospatialworld.net/Event/View.aspx?EID=43 buy clarithromycin tablets

purchasing biaxin

buy generic clarithromycin buy clarithromycin buy clarithromycin tablets

purchasing biaxin

buy generic clarithromycin buy biaxin 500mg buy clarithromycin tablets

purchasing biaxin

buy generic clarithromycin buy clarithromycin buy clarithromycin tablets

purchasing biaxin

buy generic clarithromycin buy clarithromycin buy clarithromycin tablets

order biaxin 500mg

clarithromycin buy clarithromycin clarithromycin buy

order biaxin 500mg

clarithromycin buy clarithromycin clarithromycin buy

order biaxin 500mg

clarithromycin order clarithromycin clarithromycin buy

order biaxin 500mg

clarithromycin http://www.geospatialworld.net/Event/View.aspx?EID=54&qq=buyclarithromycin clarithromycin buy

order biaxin 500mg

clarithromycin buy biaxin australia clarithromycin buy

ordering biaxin

buy generic biaxin buy clarithromycin uk buying biaxin

ordering biaxin

buy generic biaxin buy clarithromycin buying biaxin

ordering biaxin

buy generic biaxin buy biaxin canada buying biaxin

ordering biaxin

buy generic biaxin buy clarithromycin uk buying biaxin

ordering biaxin

buy generic biaxin buy clarithromycin buying biaxin

abortion pill online

where to buy abortion pill abortion pill abortion pills

abortion pill online

where to buy abortion pill abortion pill abortion pills

abortion pill online

where to buy abortion pill abortion pill abortion pills

abortion pill online

where to buy abortion pill buy abortion pills online abortion pills

abortion pill online

where to buy abortion pill abortion pill abortion pills

how to order the abortion pill online

how to order the abortion pill online http://www.geospatialworld.net/Event/View.aspx?EID=53 where can you buy the abortion pill

how to order the abortion pill online

how to order the abortion pill online abortion pill where can you buy the abortion pill

how to order the abortion pill online

how to order the abortion pill online abortion pill buy online where can you buy the abortion pill

how to order the abortion pill online

how to order the abortion pill online abortion pills where can you buy the abortion pill

how to order the abortion pill online

how to order the abortion pill online abortion pill buy online where can you buy the abortion pill

cytotec abortion

abortion pill prescription http://www.cengage.co.in/content/about-us pill for abortion online

cytotec abortion

abortion pill prescription where can i buy abortion pills pill for abortion online

cytotec abortion

abortion pill prescription abortion pill pill for abortion online

cytotec abortion

abortion pill prescription abortion pill pill for abortion online

cytotec abortion

abortion pill prescription abortion pill pill for abortion online

buy levitra online viagra

viagra suppliers in the uk viagra online viagra for sale

buy levitra online viagra

viagra suppliers in the uk viagra online viagra for sale

buy levitra online viagra

viagra suppliers in the uk viagra prescription viagra for sale

buy levitra online viagra

viagra suppliers in the uk http://www.cengage.co.in/content/privacy-statement viagra for sale

buy levitra online viagra

viagra suppliers in the uk viagra online viagra for sale

kamagra samples

kamagra 6 free samples cialis vs kamagra kamagra reviews

kamagra samples

kamagra 6 free samples http://www.cengage.co.in/content/terms-of-use kamagra reviews

kamagra samples

kamagra 6 free samples kamagra kamagra reviews

kamagra samples

kamagra 6 free samples kamagra kamagra reviews

kamagra samples

kamagra 6 free samples kamagra kamagra reviews

kamagra jelly from canada

kamagra jelly alternative generic kamagra jelly sale discount kamagra jelly

kamagra jelly from canada

kamagra jelly alternative kamagra jelly discount kamagra jelly

kamagra jelly from canada

kamagra jelly alternative kamagra jelly reviews discount kamagra jelly

kamagra jelly from canada

kamagra jelly alternative kamagra jelly reviews discount kamagra jelly

kamagra jelly from canada

kamagra jelly alternative kamagra jelly discount kamagra jelly

get amoxil

amoxil uk http://www.cengage.co.in/content/academic-professional buy cheap amoxicillin

get amoxil

amoxil uk amoxil uk buy cheap amoxicillin

get amoxil

amoxil uk http://www.cengage.co.in/content/academic-professional buy cheap amoxicillin

get amoxil

amoxil uk amoxil uk buy cheap amoxicillin

get amoxil

amoxil uk amoxicillin buy cheap amoxicillin

buy thyroxine las vegas

women does thyroxine work http://www.cengage.co.in/content/english-language-teaching free thyroxine sample

buy thyroxine las vegas

women does thyroxine work get discount synthroid online free thyroxine sample

buy thyroxine las vegas

women does thyroxine work female herbal thyroxine free thyroxine sample

buy thyroxine las vegas

women does thyroxine work get discount synthroid online free thyroxine sample

buy thyroxine las vegas

women does thyroxine work http://www.cengage.co.in/content/english-language-teaching free thyroxine sample

laxative online uk

generic laxative online http://www.cengage.co.in/content/library-reference where to buy bisacodyl online

laxative online uk

generic laxative online how does bisacodyl work where to buy bisacodyl online

laxative online uk

generic laxative online laxative where to buy bisacodyl online

laxative online uk

generic laxative online laxative where to buy bisacodyl online

laxative online uk

generic laxative online free laxative sample where to buy bisacodyl online

ampicillin for sale

principen prescription fedex generic principen buy ampicillin las vegas

ampicillin for sale

principen prescription fedex generic principen buy ampicillin las vegas

ampicillin for sale

principen prescription mail order principen buy ampicillin las vegas

ampicillin for sale

principen prescription buy cheap principen online uk buy ampicillin las vegas

ampicillin for sale

principen prescription mail order principen buy ampicillin las vegas

abortion pill buy online

where can i buy abortion pills abortion pill online purchase abortion pill

abortion pill buy online

where can i buy abortion pills buy abortion pill online purchase abortion pill

abortion pill buy online

where can i buy abortion pills abortion pill online purchase abortion pill

abortion pill buy online

where can i buy abortion pills abortion pill online purchase abortion pill

abortion pill buy online

where can i buy abortion pills http://www3.umu.se/kultmed/kurswebb/default.aspx?id=1 online purchase abortion pill

buy biaxin online

discount clarithromycin clarithromycin purchase clarithromycin

buy biaxin online

discount clarithromycin http://www3.umu.se/kultmed/kurswebb/default.aspx?id=29 purchase clarithromycin

buy biaxin online

discount clarithromycin http://www3.umu.se/kultmed/kurswebb/default.aspx?id=29 purchase clarithromycin

buy biaxin online

discount clarithromycin clarithromycin purchase clarithromycin

buy biaxin online

discount clarithromycin clarithromycin purchase clarithromycin

cipro online uk

get ciprofloxacin generic cipro female free sample cipro

cipro online uk

get ciprofloxacin generic cipro female free sample cipro

cipro online uk

get ciprofloxacin http://www.geospatialworld.net/Event/View.aspx?EID=37 female free sample cipro

cipro online uk

get ciprofloxacin http://www.geospatialworld.net/Event/View.aspx?EID=37 female free sample cipro

cipro online uk

get ciprofloxacin ciprofloxacin female free sample cipro

photos clindamycin

buy cleocin online http://www.geospatialworld.net/Event/View.aspx?EID=62 purchase clindamycin online

photos clindamycin

buy cleocin online clindamycin online shop in uk purchase clindamycin online

photos clindamycin

buy cleocin online clindamycin purchase clindamycin online

photos clindamycin

buy cleocin online female free sample clindamycin purchase clindamycin online

photos clindamycin

buy cleocin online female free sample clindamycin purchase clindamycin online

buy dexamethasone las vegas

dexamethasone equivalent http://www.geospatialworld.net/Event/View.aspx?EID=44 free dexamethasone sample

buy dexamethasone las vegas

dexamethasone equivalent http://www.geospatialworld.net/Event/View.aspx?EID=44 free dexamethasone sample

buy dexamethasone las vegas

dexamethasone equivalent dexamethasone free dexamethasone sample

buy dexamethasone las vegas

dexamethasone equivalent women does dexamethasone work free dexamethasone sample

buy dexamethasone las vegas

dexamethasone equivalent alternative to dexone free dexamethasone sample

order Cefadroxil online

order Cefadroxil online get Cefadroxil avoid prescription how to use Cefadroxil

order Cefadroxil online

order Cefadroxil online generic Cefadroxil how to use Cefadroxil

order Cefadroxil online

order Cefadroxil online cefadroxil how to use Cefadroxil

order Cefadroxil online

order Cefadroxil online cefadroxil how to use Cefadroxil

order Cefadroxil online

order Cefadroxil online cefadroxil how to use Cefadroxil

vantin online shop in uk

buy cefpodoxime online a href get discount vantin online purchase vantin online

vantin online shop in uk

buy cefpodoxime online a href cefpodoxime purchase vantin online

vantin online shop in uk

buy cefpodoxime online a href cefpodoxime purchase vantin online

vantin online shop in uk

buy cefpodoxime online a href vantin for sale purchase vantin online

vantin online shop in uk

buy cefpodoxime online a href cefpodoxime purchase vantin online

generic ceftin

photos ceftin cefuroxime female free sample ceftin

generic ceftin

photos ceftin http://www.geospatialworld.net/Event/View.aspx?EID=154 female free sample ceftin

generic ceftin

photos ceftin http://www.geospatialworld.net/Event/View.aspx?EID=154 female free sample ceftin

generic ceftin

photos ceftin mail order cefuroxime female free sample ceftin

generic ceftin

photos ceftin http://www.geospatialworld.net/Event/View.aspx?EID=154 female free sample ceftin

abortion pills

how to order the abortion pill online where to buy abortion pills online medical abortion pill online

abortion pills

how to order the abortion pill online buy abortion pills online medical abortion pill online

abortion pills

how to order the abortion pill online http://ateneobergamo.it/schedaNews.aspx?id=216 medical abortion pill online

abortion pills

how to order the abortion pill online http://ateneobergamo.it/schedaNews.aspx?id=216 medical abortion pill online

abortion pills

how to order the abortion pill online abortion pill online medical abortion pill online

buy keflex online safe

generic keflex sale cephalexin get discount keflex online

buy keflex online safe

generic keflex sale http://www.fareastjournals.com/conf_detail.aspx?conf_id=5 get discount keflex online

buy keflex online safe

generic keflex sale women does keflex work get discount keflex online

buy keflex online safe

generic keflex sale cheap cephalexin tablets get discount keflex online

buy keflex online safe

generic keflex sale buy cephalexin las vegas get discount keflex online

buy chloromycetin online

chloromycetin for sale chloromycetin online shop in uk get chloromycetin

buy chloromycetin online

chloromycetin for sale chloramphenicol get chloromycetin

buy chloromycetin online

chloromycetin for sale http://www.fareastjournals.com/conf_detail.aspx?conf_id=6 get chloromycetin

buy chloromycetin online

chloromycetin for sale get chloromycetin get chloromycetin

buy chloromycetin online

chloromycetin for sale chloramphenicol get chloromycetin

where can you buy the abortion pill

ordering abortion pills to be shipped to house order abortion pill how to order the abortion pill online

where can you buy the abortion pill

ordering abortion pills to be shipped to house order abortion pill how to order the abortion pill online

where can you buy the abortion pill

ordering abortion pills to be shipped to house abortion pill how to order the abortion pill online

where can you buy the abortion pill

ordering abortion pills to be shipped to house cytotec abortion pill buy online how to order the abortion pill online

where can you buy the abortion pill

ordering abortion pills to be shipped to house http://www.fareastjournals.com/journal_detail.aspx?jid=18 how to order the abortion pill online

clavulanate for sale

buy cheap clavulanate online uk augmentin clavulanate without prescription

clavulanate for sale

buy cheap clavulanate online uk augmentin clavulanate without prescription

clavulanate for sale

buy cheap clavulanate online uk natural augmentin clavulanate without prescription

clavulanate for sale

buy cheap clavulanate online uk get augmentin avoid prescription clavulanate without prescription

clavulanate for sale

buy cheap clavulanate online uk women does clavulanate work clavulanate without prescription