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3.7 Payment mechanisms
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4.1 Physical resources
Three steps need to be taken to enter the Slovak health care provision market. First, the health care professionals have to obtain a licence from the Slovak Medical Chamber. Second, the provider has to obtain a permit from the self-governing region or the Ministry of Health depending on what type of provider it is. In this step, the health care facility is required to meet certain technical conditions as well as certain personnel requirements. Third, providers need to submit a request for a contract with a given health insurance company. However, it needs to be noted that meeting the first two conditions does not guarantee obtaining a contract and that providers may also provide services without a contract with a health insurance company.
Health care workers may receive professional qualifications in four ways. They may complete (1) a Bachelor’s or Master’s degree in an accredited university programme, or (2) higher vocational training, (3) full secondary vocational training, or (4) secondary vocational training in degree programmes of secondary health schools.
Compared to other countries, the number of physicians and nurses per capita was similar to those of the EU15 until 2001. After 2001, Slovakia witnessed a continuous fall in the number of physicians and nurses in relation to the population, although their numbers remain above the EU12 average. These changes are closely linked with the migration of doctors and nurses abroad and the restructuring of health care facilities. National data show that, since 2006, the health workforce has started to increase again. Yet the ageing workforce combined with migration of health care workers may reinforce the shortage of health care workers. Although exact data on migration are lacking, this is considered common knowledge.