hospitaluri seqtoris reformis monitoringis xelSewyoba Healthcare Refor… · mieraa miRebuli. jandacvis ufleba ganuyofelia adamianis sxva socialuri, ekonomikuri, kulturuli, samoqalaqo

hospitaluri seqtoris reformis

monitoringis xelSewyoba

2007 wlis oqtombridan 2008 wlis maisis CaTvliT “saerTaSoriso gamWvirvaloba

saqarTvelom” ganaxorciela “evraziis partniorobis fondis” mier dafinansebuli

proeqti saxelwodebiT “hospitaluri seqtoris reformis monitoringis xelSewyoba”.

proeqti miznad isaxavda am seqtorSi mimdinare privatizaciis procesis Sefasebas da

mis Sesaxeb samedicino da zogadad, sazogadoebis ukeT informirebas.

proeqtis farglebSi “saerTaSoriso gamWvirvaloba saqarTvelom” Caatara

hospitaluri seqtoris privatizaciis monitoringi, Seiswavla kerZo investorebsa da

saxelmwifos Soris dRemde dadebuli xelSekrulebebi, Caatara samedicino

personalisa da saavadmyofoebis xelmZRvaneli pirebis gamokiTxva mimdinare

reformasTan dakavSirebul sakiTxebze da am sferoSi momuSave qarTuli da

saerTaSoriso organizaciebis SeniSvnebisa da winadadebebis gaTvaliswinebiT moamzada

rekomendaciebi seqtoris reformis daxvewisTvis.

janmrTelobis dacvis ufleba

janmrTelobis dacva farTo cnebaa da masze mravali faqtori axdens gavlenas.

“msoflios jandacvis organizaciis” (WHO) konstitucia “janrmTelobas” ganmartavs

rogorc srul fizikur, mentalur da socialur keTildReobas da ara rogorc

mxolod konkretuli daavadeb(eb)is arqonas. amave konstituciaSi aRniSnulia, rom

janmrTelobis umaRlesi standartebis uzrunvelyofa TiToeuli adamianis

fundamenturi uflebaa ganurCevlad misi rasis, religiis, politikuri mrwamsis,

rwmenis da social-ekonomikuri mdgomareobisa.

janmrTelobis ufleba bevr sxva saerTaSoriso dokumentSia xazgasmuli. “adamianis

uflebaTa universaluri deklaraciis” ocdamexuTe muxlis Tanaxmad, yvelas aqvs

ufleba hqondes cxovrebis iseTi pirobebi (maT Soris, sakvebi produqtebi,

tansacmeli, sacxovrebeli, samedicino momsaxureba da a.S.), romliTac daculi iqneba

misi da misi ojaxis wevrebis janmrTeloba da srulfasovani arseboba.

bunebrivia, am saerTaSoriso aqtebs didi mniSvneloba eniWeba, Tumca janmrTelobis

dacvis uflebis uzrunvelyofa, pirvel rigSi, erovnul doneze xdeba. jandacvis

sakiTxs eTmoba saqarTvelos konstituciis ocdameCvidmete muxli da mTeli rigi

kanonebi da samarTlebrivi aqtebi, romlebic saqarTvelos parlamentisa da mTavrobis

mieraa miRebuli. jandacvis ufleba ganuyofelia adamianis sxva socialuri,

ekonomikuri, kulturuli, samoqalaqo da politikuri uflebebisgan. samedicino

kvleva Catarda “evraziis partniorobis fondis” finansuri mxardaWeriT.

es angariSi momzadebulia “saerTaSoriso gamWvirvaloba saqarTvelos” mier da is ar

gamoxatavs donori organizaciis oficialur pozicias.

2

momsaxureba xelmisawvdomi unda iyos yvelasTvis.

2000 wlis “msoflios janmrTelobis angariSi1” jandacvis sferos sam ZiriTad

funqciad asaxelebs: mosaxleobisTvis janmrTelobis pirobebis Seqmnas, samedicino

momsaxurebis qveynis realur saWiroebebze morgebas da misi finansuri

xelmisawvdomobis uzrunvelyofas. bunebrivia, am funqciebis SesrulebaSi

hospitalur seqtors centraluri adgili ukavia2. Sesabamisad, misi reformirebis

strategia mecnierul kvlevebsa da sferoSi arsebul saukeTeso praqtikaze unda iyos

damyarebuli da emsaxurebodes seqtoris efeqturobis, moqnilobis da

xelmisawvdomobis gazrdas. hospitaluri seqtori izolaciaSi ar arsebobs. masze mniSvnelovan gavlenas axdens

is, Tu ra xdeba qveynis ekonomikaSi, socialur sferoSi, politikaSi, rogoria

mosaxleobis molodinebi da saWiroebebi. Sesabamisad, hospitaluri seqtoris

efeqturi funqcionirebisTvis aucilebelia, rom masze gavlenis mqone sxvadasxva

faqtorebi, maTi gavlenis Sedegebi, sazogadoebaSi arsebuli SesaZleblobebi da

moTxovnebi da zogadad, qveyanaSi arsebuli resursebi sworad iqnas gaanalizebuli. saqarTvelos jandacvis sferos ganviTarebis winaistoria sabWoTa periodSi saqarTvelos jandacvis sistema, bunebrivia, sabWoTa sistemis

nawils warmoadgenda da am sistemis Sesabamisad funqcionirebda. normatiuli

dagegmareba SemuSavebuli iyo “socialuri higienisa da sajaro administraciis”

moskovis kvleviTi institutis mier da is mTel sabWoTa sivrceze erTnairad

vrceldeboda. am modelisTvis damaxasiaTebeli iyo sami ZiriTadi Tviseba: sawolebis

didi raodenoba, pacientebis dabali gamtarianoba da jandacvis biujetSi

saavadmyofoebis dafinansebis dominireba3. 1991 wels, roca saqarTvelom

damoukidebloba moipova, jandacvis sferoSi miwodeba bevrad aRemateboda moTxovnas

rogorc infrastruqturis, ise samedicino personalis raodenobis kuTxiT. Semdgomi

finansur-ekonomikuri krizisis Sedegad jandacvis sistema mniSvnelovnad gauaresda.

saxelmwifos aRar hqonda imis SesaZlebloba, rom daefinansebina Warbi raodenobis

saavadmyofoebi da samedicino personali da samedicino momsaxurebis xarisxi nel-

nela gauaresda. oTxmocdaaTian wlebSi saqarTvelos xelisuflebam daiwyo jandacvis sferos

1 “msoflios jandacvis organizaciis” 200 wlis angariSi. “janmrTelobis sistemebi: saqmianobis

daxvewa”. Jeneva, 2000 w. 2 m. maqqi, j. edsi, “hospitalebis kvleva” (Tavi 7). Ria universiteti, 2002 w, 119. 3 hospitaluri seqtori centralur da aRmosavleT evropaSi, saavadmyofoebis reformireba post-sabWoTa qveynebSi. meSvide tomi, mesame gamocema, specialuri gamoSveba, ISSN1356-1030.




3

reformireba. am procesSi aqtiurad monawileobdnen saerTaSoriso organizaciebi,

romlebic saqarTvelos finansur da eqspertul daxmarebas uwevdnen. 1994-1995

wlebSi mTavrobam msoflio banks mimarTa TxovniT, rom CarTuliyo saqarTvelos

hospitaluri seqtoris racionalizaciisa da optimizaciis gegmis SemuSavebasa da

finansur uzrunvelyofaSi. msoflio bankma hospitalebis restruqturizaciis gegmis

SemuSaveba 1998 wels daasrula. masSi detalurad iyo gawerili hospitaluri

seqtoris xarisxobrivi da raodenobrivi maCveneblebi mocemuli etapisTvis da

warmodgenili iyo hospitaluri seqtoris privatizaciis gegma. es gegma gulisxmobda

seqtoris sam jgufad dayofas: A jgufis saavadmyofoebi saxelmwifo sakuTrebaSi

unda darCeniliyo, B jgufis saavadmyofoebi unda gadasuliyo kerZo sakuTrebaSi,

Tumca maT unda SeenarCunebinaT profili da C jgufis saavadmyofoebi unda

gayiduliyo rogorc ubralod uZravi qoneba (profilis SenarCunebis valdebulebis

gareSe)4. msoflio bankis gegmaSi erT-erT mTavar punqtad aRniSnuli iyo, rom unda

Seqmniliyo specialuri struqtura, romelic uzrunvelyofda hospitaluri seqtoris

optimizaciasTan dakavSirebuli iuridiuli sakiTxebis daregulirebas da

“hospitaluri seqtoris restruqturizaciis fondis5” administrirebas. am fondSi

Cairicxeboda B jgufis saavadmyofoebis privatizaciidan miRebuli Tanxebi da

SemdgomSi es Tanxebi gamoyenebuli iqneboda jandacvis sferos infrastruqturisa da

teqnikis ganaxlebisTvis.

am periodSi saqarTvelos mTavrobas daxmareba “aSS-s saerTaSoriso ganviTarebis

saagentomac” (USAID) gauwia. es organizacia, ZiriTadad, saavadmyofoebis

akreditaciis sistemis SemuSavebis procesSi iyo CarTuli. jandacvis sferos

reformis SemuSavebasa da ganxorcielebaSi monawileobas sxvadasxva saxiTa da doziT

sxva saerTaSoriso sazogadoebrivi da samTavrobo organizaciebic iRebdnen6. miuxedavad am iniciativebisa da mxardaWerisa, saqarTvelos maSindelma xelisuflebam

ver SeZlo jandacvis sferos ganviTarebis mimarTulebiT qmediTi nabijebis gadadgma.

amas ramdenime mizezi hqonda: erTis mxriv, mTavrobas ar hqonda sakmarisi finansebi,

rom procesi efeqturad waremarTa; meores mxriv, mas ar hqonda imis unari, rom

sferos regulireba moexdina; politikuri zewolis gamo man Tavi aarida

saavadmyofoebis gayidvas da maTi raodenobis Semcirebas da rac mTavaria,

xelisuflebis efeqtur saqmianobas xeli masSi arsebulma korufciamac SeuSala.

4 am gegmas radikalurad daupirispirda maSindeli opozicia. maT Soris iyo 2003 wlis revoluciis

Semdeg jandacvis ministrad daniSnuli vladimer WipaSvilic, romelic maSin parlamentis wevri iyo. Sedegad gegmis implementacia ver moxerxda. ministrad daniSvnis Semdeg vladimer WipaSvilma moiwvia

ori ucxouri kompania – Conseil Sante da Scandinavian Care – da maT hospitaluri seqtoris

racionalizaciis meore gegmis SemuSavebaSi daxmareba sTxova. 5 msoflio bankma saqarTvelos mTavrobas “struqturuli reformis kreditis” farglebSi 5 mln. aSS

dolari gamouyo. 6 damatebiTi informaciisTvis ixileT saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros oficialuri vebgverdi http://www.moh.gov.ge.

http://www.moh.gov.ge/

saboloo jamSi, mravali mcdelobis miuxedavad, hospitaluri seqtoris efeqturi

marTva, samedicino momsaxurebis xarisxianoba da misi xelmisawvdomoba kvlav

problemur sakiTxebad darCa.

jandacvis sfero 2001-2006 wlebSi “msoflios jandacvis organizaciis” monacemebiT,7 2006 wels saqarTveloSi 269

saavadmyofo iyo (yovel 100 000 adamianze 5.96 saavadmyofo). am maCveneblis mixedviT

saqarTvelo mniSvnelovnad uswrebda evrokavSiris da post-sabWoTa qveynebs.

magaliTad, evropis regionSi (dasavleT da aRmosavleT evropis qveynebi) am dros

yovel 100 000 adamianze saSualod 3.76 saavadmyofo iyo, evrokavSiris qveynebSi –

yovel 100 000 adamianze 3, dsT-s qveynebSi – yovel 100 000 adamianze 4.96 da

centraluri aziis qveynebsa da yazaxeTSi – yovel 100 000 adamianze 4.76 (cxrili

1).

cxrili 1: saavadmyofoebis raodenoba yovel 100 000 adamianze

4.76 4.96

3

3.76

5.96

0

1

2

3

4

5

6

saqarTvelo evrokavSiri dsT

evropis centr. azia

regioni da yazaxeTi

2001-2006 wlebSi sawolebis raodenoba Semcirda. 2001 wels sawolebis saerTo

raodenoba saqarTveloSi 19 530 iyo (yovel 100 000 adamianze 429.6 sawoli),




4

xolo 2006 wels – 16,455 (yovel 100 000 adamianze 374.2 sawoli).

7 “janmrTeloba yvelasTvis” monacemTa baza (HFA-DB), msoflios jandacvis organizacia; evropis regionuli ofisi. 2007 wlis noembris monacemebi.




5

periodSi sawolebis raodenobis Semcireba damaxasiaTebeli iyo ara mxolod

rili 2: sawolebis mTliani raodenoba saqarTveloSi

am

saqarTvelosTvis, aramed post-sabWoTa sivrcis sxva qveynebisTvisac (cxrili 2 da

cxrili 3).

cx

16455

17095

17806

18151

19530

18290

15500

16000

16500

17000

17500

18000

18500

19000

19500

20000

2001 2002 2003 2004 2005 2006

rili 3: sawolebis raodenoba yovel 100 000 adamianze saqarTveloSi cx

374.2

392.0

407.3

419.3419.8

429.6

350

360

370

380

390

400

410

420

430

440

2001 2002 2003 2004 2005 2006




6

2001-2006 wlebSi saqarTveloSi sawolebis raodenobis Semcirebis miuxedavad,

sawolebis datvirTvis maCvenebeli kvlav dabali darCa. 2006 wels am maCveneblis

mixedviT saqarTvelo erT-erT bolo adgilze iyo post-sabWoTa da aRmosavleT da

dasavleT evropis qveynebTan SedarebiT. kerZod, saqarTveloSi sawolebis datvirTvis

maCvenebeli am periodSi iyo 32.3%, evrokavSiris qveynebSi – 75.85%, evropis

regionSi – 79.6%, dsT-s qveynebSi – 83.61% da centralur aziasa da yazaxeTSi –

76.16%. sawolebis dabali datvirTvis erT-erT mTavar mizezs saqarTveloSi,

savaraudod, mosaxleobis mZime finansuri mdgomareoba warmoadgenda (cxrili 4,

cxrili 5, cxrili 6).

cxrili 4: sawolebis datvirTva

26.8

27.2

25.825.4

23.2

25

30

32.3

15

20

35

2001 2002 2003 2004 2005 2006




7

cxrili 5: sawolebis datvirTva (procentuli maCvenebeli)

0 10 20 30 40 50 60 70 80 9

2001

2002

2003

2004

2005

2006

0

CARK 83.6 81.3 78.4 84.6 83.3 76.2CIS 84.3 84.1 84.2 85.7 85.1 83.6European Union 76.7 76.7 76.2 75.9 75.9 0European Union 79.8 79.8 79.5 80 79.6 0Georgia 23.2 25.4 25.8 27.2 26.8 32.3

2001 2002 2003 2004 2005 2006

cxrili 6: sawolebis datvirTva yovel 100 000 adamianze (2005 w.)

ungreTi ruseTi litva CexeTi ukraina germania

dsT latvia

evrokavSiri slovakeTi

evropis regioni israeli norvegia yazaxeTi slovenia

moldova SvedeTi uzbkeTi

xorvatia

irlandia yirgizeTi

malta montenegro tajikeTi

andora makedonia somxeTi kviprosi

saqareTvelo azerbaijani

evrokavSiri* -

0 5 10 15 20

centr. azia da yazaxeTi

25




8

*evrokavSiris wevri qveynebi 2004 an 2007 wlidan. 2001-2006 wlebSi saqarTvelos jandacvis sferoSi samedicino personalis sakmaod

didi raodenoba iyo dasaqmebuli. sxva sabWoTa qveynebis msgavsad, viwro

specializaciis eqimebis raodenoba mkveTrad aRemateboda zogadi praqtikosebisa

(Terapevtebis) da ojaxis eqimebis raodenobas. am periodSi ganxorcielebul

reformebs Sedegad samedicino personalis raodenobis Semcireba ar mohyolia,

piriqiT, 2001-2006 wlebSi yovel 100 000 adamianze eqimebis raodenoba gaizarda. am

periodSi eqimebis raodenoba yvelaze naklebi iyo centraluri aziasa da yazaxeTSi

da yvelaze meti – saqarTveloSi (cxrili 7 da cxrili 8).

cxrili 7: eqimebis raodenoba yovel 100 000 adamianze saqarTveloSi

468.3465.7464.2

489.4

484.2

429.6

410

430

450

470

490

510

2001 2002 2003 2004 2005 2006




9

jandacvis sferos mdgomareobis Sefasebis kidev erTi mniSvnelovani kriteriumi

samedicino personalis, eqimebisa da eqTnebis Sefardeba da kvalifikaciis donea.

sabWoTa modeliT eqTnebi, rogorc wesi, naklebad kvalificiurebi iyvnen da isini

faqtobrivad mxolod eqimebis damxamreebis funqcias asrulebdnen8. am periodSi

saqarTveloSi yovel 100 000 adamianze eqTnebis raodenoba Semcirda (gansxvavebiT

imebis raodenobisgan).

06 wels saqarTvelos TiTqmis orjer naklebi eqTani hyavda mis mezobel qveynebTan

darebiT. eqimebis eqTnebTan Sefardeba am dros 1 : 1.2 iyo. “msoflios jandacvis

ganizaciis” rekomendaciiT es Sefardeba 1 : 4 unda iyos (cxrili 9 da cxrili

).

cxrili 8: eqimebis raodenoba yovel 100 000 adamianze regionSi

eq

20

Se

or

10

dRes eqTnebis roli mniSvnelovnad gazrdilia. saerTaSoriso organizaciebis daxmarebiT

rcieldeba sxvadasxva saxis programebi, romlebic eqTnebis kvalifikaciis amaRlebas da samedicino msaxurebis gawevaSi maTi rolis gazrdas emsaxureba.

8 xomo

0 100 200 300 400 500 600

2001

2002

2003

2004

2005

2006

centr. azia, yaz. 294.4 293.1 289.6 286.4 282.9 286.0 dsT 370.2 373.6 373.3 371.5 372.0 377.4 evrokavSiri 312.5 316.4 317.9 320.0 315.0 315.0 evropis regioni 333.8 338.8 338.1 339.0 336.2 338.2 saqarTvelo 429.6 464.2 484.2 489.4 465.7 468.3

2001 2002 2003 2004 2005 2006




10

Si cxrili 9: eqTnebis raodenoba yovel 100 000 adamianze saqarTvelo

379.1

395.9396.5

422.7

431.5434.4

370

380

390

400

410

420

430

440

2001 2002 2003 2004 2005 2006

cx

rili 10: eqTnebis raodenoba yovel 100 000 adamianze regionSi

2003

2004

2005

2006

2001

2002

0 100 200 300 400 500 600 700 800 900

centr. azia, yaz. 769.2 767.7 759.8 756.6 766.7 778.3 dsT 785.8 794.2 789.3 785.2 788.3 794.9 evrokavSiri 682.7 699.9 706.2 725.6 736.0 741.6

evropis regioni 672.0 685.5 686.8 702.1 713.3 720.3 saqarTvelo 422.7 431.5 434.3 396.5 395.9 379.1

2001 2002 2003 2004 2005 2006




11

jandacvis reforma 2003 wlis revoluciis Semdeg 2003 wlis vardebis revoluciis Semdeg mosulma xelisuflebam jandacvis sferos

reformirebis procesSi erT-erT mTavar miznad hospitaluri seqtoris reabilitacia

daisaxa. 2007 wlis ianvarSi maSindelma premier-ministrma zurab noRaidelma xeli

moawera “hospitaluri seqtoris ganviTarebis generalur gegmas”, romlis Tanaxmadac

am gegmis ganxorcielebis (sami wlis) Semdeg saqarTveloSi iqneboda 100 axali

saavadmyofo 7 800 sawoliT (4 185 sawoli – TbilisSi da 3 615 – regionebSi9). hospitaluri seqtoris reabilitaciis programa “100 axali saavadmyofos”

saxelwodebiT gaxda cnobili. misi ZiriTadi arsi imaSi mdgomareobs, rom

saxelmwifos sakuTrebaSi da saxelmwifo dafinansebaze arsebuli yvela saavadmyofo

privatizaciis gziT kerZo sakuTrebaSi unda gadavides. xelisuflebam miiCnia, rom

amiT is xels Seuwyobda seqtorSi kerZo investiciebis mozidvas, saavadmyofoebs

Soris konkurenciis gazrdas da Sesabamisad, maT mier gaweuli samedicino

momsaxurebis xarisxis amaRlebas.

hospitaluri seqtoris reabilitaciis (generaluri gegmis ganxorcielebis) vadad

lisuflebam sami weli gansazRvra, Tumca saavadmyofoebis privatizaciis procesi

ireba

ess

i

iwro

ebad

is

ifo

uri

s

ebs

m

xe

erT welSi unda dasrulebuliyo. am procesis (privatizaciis) administr

ekonomikuri ganviTarebis saministros daevala, vinaidan privatizaciis proc

saqarTveloSi zogadad swored is kurirebs. Sromis, janmrTelobisa da socialuri

dacvis saministrom, bunebrivia, SeinarCuna saavadmyofoebis licenzirebis funqcia.

privatizaciis gegmis Tanaxmad, axali saavadmyofoebi geografiulad ise unda

gadanawildes, rom mosaxleobis 80%-sTvis samedicino momsaxureba maqsimum 30 wuTS

iyos xelmisawvdomi. garda amisa, is aseve iTvaliswinebs sabWoTa periodis v

specializaciis saavadmyofoebis zogadi (Sereuli) profilis saavadmyofo

gardaqmnas.

hospitalur seqtoris privatizaciisgan saxelmwifo finansur resurss ar iRebs.

investors gadascems im teritoriebs, sadac amJamad ganTavsebulia saxelmw

sakuTrebaSi arsebuli saavadmyofoebi da sanacvlod maTgan iTxovs, rom aaSenon da

aRWurvon axali saavadmyofoebi (1) igive teritoriaze, an (2) ekonomik

ganviTarebisa saministrosa da Tbilisis meriis an Sesabamisi teritoriuli organo

mier specialurad amisTvis gamoyofil arasasoflo-sameurneo miwaze10. investor

ekisrebaT valdebuleba, rom axali an reabilitirebuli saavadmyofoebi amuSaon

minimum Svidi wlis ganmavlobaSi; Svidi wlis Semdeg maT eZlevaT ufleba, ro

saavadmyofoebis geografiuli danawileba da sawolebis optimaluri raodenoba gansazRvrulia

rTelobisa da socialuri dacvis saministros mier. gadawyvetilebas imis Sesaxeb, Tu sad unda aSendes axali saavadmyofoebi iRebs saxelmwifo da ara

investori.

9 Sromis, janm10




12

ebi sxva daniSnulebiT

amoiyenon.

enderebis Sesaxeb gancxadebebi Tavsdeboda (da Tavsdeba) ekonomikuri ganviTarebis

saavadmyofoebis Senoba-nagebobebi da Sesabamisi teritori

g

saxelmwifo sakuTrebaSi arsebuli saavadmyofoebi da damatebiTi teritoriebi, sadac

axali saavadmyofoebi unda aSendes investorebs lotebad gadaecemaT. am lotebSi,

Cveulebriv, Sedis garkveuli teritoria TbilisSi (rac investorebisTvis

gansakuTrebiT mimzidvelia) da specialurad saavadmyofoebisTvis gamoyofili

teritoriebi regionebSi. am “erTiani paketis” midgomis upiratesoba imaSi

mdgomareobs, rom investorebi, maTTvis SedarebiT prestiJuli teritoriebis

gadacemis sanacvlod, axal saavadmyofoebs saqarTvelos aqamde naklebad ganviTarebul

mxareebSic aaSeneben.

hospitaluri seqtoris privatizaciis procesi t

saministros specialur vebgverdze www.privatization.ge da yovelkvireul JurnalSi

“mesakuTre”. amave saSualebebiT qveyndeboda tenderebis saboloo Sedegebic. aRniSnul

vebgverdsa da JurnalSi sxvadasxva dros ganTavsebuli oficialuri informaciis

analizisas aSkarad ikveTeba, rom tenderebis pirobebi da gamarjvebuli investorebis

SerCevis kriteriumebi etapobrivad ixveweboda. pirvel oTx tenderSi (es tenderebi

2007 wlis 11 ianvridan 30 martamde SualedSi Catarda) erTaderT kriteriumad

vestorebis mier SeTavazebuli sawolebis raodenoba gamoiyeneboda – tenderSi

icodnen, Tu ris safuZvelze moxdeboda gamarjvebulis SerCeva).

marjvebuli investoris sawolebis raodenobis mixedviT SerCeva pirdapir

sabanko garantiebi da mSeneblobis dasrulebis vadebi. amis Sesaxeb pirveli sajaro

in

imarjvebda is investori, romelic mTavrobas sawolebis yvelaze met raodenobas

SesTavazebda, miuxedavad imisa, Tu ra finansuri resursis Cadebas apirebda is am

sawolebSi. aqve unda aRiniSnos, rom kriteriumebis Sesaxeb cnobili xdeboda

mxolod tenderebis dasrulebis Semdeg da ara maTi gamocxadebisas (investorebma

winaswar ar

ga

ewinaaRmdegeboda hospitaluri seqtoris reabilitaciis procesis erT-erT mTavar

mizans, rac sawolebis raodenobis optimizacias da amis xarjze finansuri

resursebis ufro racionalur gamoyenebas da jandacvis sferos efeqturobis

gazrdas gulisxmobda. mexuTe tenderis Sedegebis gamocxadebisas mTavrobam gamarjvebuli investoris

SerCevis SedarebiT ufro detaluri kriteriumebi warmoadgina. manamde arsebul

erTaderT kriteriums (sawolebis raodenobas) daemata ori axali kriteriumi –

gancxadeba ekonomikuri ganviTarebis maSindelma ministrma 2007 wlis 19 aprils

gaakeTa.




13

armoadgenda, rom mTavrobas hqonoda imis garantiebi, rom konkursSi

nawile investorebs realurad hqondaT sakmarisi finansuri resursebi maTze

erCevis erT-erT kriteriumad sabanko garantiis damatebis

g Catarebuli tenderebis analiziT cxadyofs, rom investorebis garkveuli

wili xelisuflebas gacilebiT maRal sabanko garantiebs warudgenda (zogierT

lebis minimaluri moTxovnis

anaxmad iyo gansazRvruli da konkursebSi, rogorc wesi, swored aseTi investorebi

a hospitaluri reformis TxuTmeti proeqti . am proeqtebis

arglebSi saprivatizaciod gamotanilia 193 saavadmyofo, maTgan 18 TbilisSia da

ekonomikuri ganviTarebis saministros ganmartebiT, sabanko garantiis moTxovnis

mizans is w

mo

aRebuli valdebulebebis Sesasruleblad. saministros gaangariSebiT, erT sawolis

aRWurva da operireba (zogadi profilis saavadmyofoSi) saSualod 42 000 aSS

dolaris investicias moiTxovda. saministrom es Tanxa daaxloebiT samze gayo da

TiToeul sawolze minimaluri dasaxarji Tanxa 15 000 aSS dolariT gansazRvra.

Sesabamisad, Tu romelime investori saxelmwifos assawoliani saavadmofos aSenebas

SesTavazebda, mas ganacxadisTvis unda daerTo 1.5 milioni aSS sabanko garantiis

damadasturebeli sabuTi (100 sawoli x 15 000 aSS dolarze = 1,5 milioni aSS

dolari). investoris S

Semde

na

SemTxvevaSi – 22-25-jer metsac), vidre es xelisuf

T

imarjvebdnen, miuxedavad imisa, rom, bunebrivia, maRali sabanko garantia imas ar

niSnavs, rom investori am Tanxas mTlianad saavadmyofos aSenebasa da aRWurvaSi

Cadebs.

rac Seexeba meore axal kriteriums – mSeneblobis vadis dasrulebas – evropuli

standarebis Tanaxmad, axali saavadmyofos aSenebasa da mis srulad aRWurvas

daaxloebiT xuTi-eqvsi weli sWirdeba. imis gamo, rom tenderebis gamocxadebisas

xelisuflebam aqcenti mSeneblobis dasrulebaze gaakeTa, investorebis nawilma

yuradReba swored mSeneblobis vadebze gadaitana da Sedegad, rigi ufro

mniSvnelovani faqtorebisa meore planze gadavida. meeqvse da meSvide tenderebSi pirvelad gaCnda iseTi damatebiTi pirobebi, rogoricaa

privatizebul saavadmyofoebSi manamde arsebuli departamentebis

SenarCuneba/ganaxleba, sxvadasxva saxis samedicino teqnikis Sesyidva, garkveuli

Senoba-nagebobebis dangreva/demontaJi da privatizebul saavadmyofoebSi ganTavsebuli

devnilebis koleqtiuri sacxovreblebis gauqmeba. am etapze SemuSavebuli 11

f

175 – regionebSi. 2008 wlis TebervlisTvis saxelmwifos xelmowerili hqonda sami

proeqtis xelSekruleba: pirveli, mexuTe da merve12. mecxre, meaTe, meTerTmete,

meTormete, mecamete, meToTxmete da meTxuTmete proeqtebTan dakavSirebuli

xelSekrulebebi amJamad muSavdeba. mesame da meSvide proeqtebi wardgenilia

11 saqarTvelos Sromis, janmrTelobisa da socialuri dacvis saministros oficialuri informaciis

naxmad. Ta




14

ra teqnikiT unda iyos is aRWurvili. gamarjvebuli investoris

rCevis ZiriTadi kriteriumebi am SemTxvevaSi mSeneblobis dasrulebis vada da

“aversi farma”. xelSekrulebis

anaxmad, investorma unda aaSenos asormocdaaTsawoliani zogadi profilis

ospitaluri seqtoris privatizaciis procesis Sefaseba samedicino

sazogadoebis warmomadgenlebma.

tarda interviuebisa da kiTxvarebis gamoyenebiT. samedicino sazogadoebidan

mTavrobaSi da ganxilvis procesSia.

proeqti #1 moicavs zugdidis saavadmyofoebs da hematologiisa da transfuziis

mecnieruli kvlevis instituts. gaformebuli xelSekrulebis Tanaxmad, investorma

unda aaSenos zogadi profilis assawoliani saavadmyofo diRomSi, SeakeTos zugdidis

ramdenime saavadmyofo da Seqmnas sisxlis banki. xelSekrulebis darRvevis

SemTxvevaSi investors daekisreba garkveuli sanqciebi.

proeqti #5 moicavs Sps m. winamZRvriSvilis saxelobis kardiologiuri mecnieruli

klvevis instituts, Sps Tbilisis meoTxe klinikur saavadmyofos, Sps m.

guramiSvilis saxelobis pediatriul klinikas, Sps Tbilisis sameano saxls da Sps

kardiologiur klinikas. am proeqtSi oficialuri gamarjvebulia Block Georgia,

Tumca rogorc “saerTaSoriso gamWvirvaloba saqarTvelos” samedicino sferos

warmomadgenlebma uTxres, menejmentis procesSi farmacevtuli kompaniis “aversi

farmas” monawileoba SeiniSneba. investorma unda aaSenos zogadi profilis

asoTxmocdaaTsawoliani saavadmyofo sanzonaSi (17 TveSi). xelSekrulebaSi 1

miTiTebulia, Tu ra saxis samedicino momsaxurebebi unda gaswios axalma

saavadmyofom da

Se

investoris sabanko garantia iyo.

proeqti #5 moicavs ofTalmologiisa da nevrologiis erovnul centrs, Salva

qoriZis saxelobis sameano saxls da plastikuri qirurgiis centri. proeqtSi

oficialuri gamarjvebuli “unimSenia”, Tumca am SemTxvevaSic, samedicino personalis

cnobiT, procesSi CarTulia farmacevtuli kompania

T

saavadmyofo orTaWalaSi (ocdasam TveSi). is unda iyos srulad aRWurvili. aqac

investoris SerCevis ZiriTad kriteriumebad gamoyenebuli iqna sabanko garantiebi da

mSeneblobis dasrulebis vadebi. h

sazogadoebis mier jandacvis sferoSi mimdinare procesebis Sesaxeb sxvadasxva interes jgufebis

Sefasebebisa da rekomendaciebis gasacnobad “saerTaSoriso gamWvirvaloba

saqarTvelom” Caatara kvleva, romelSic monawileoba miiRes qarTuli da

saerTaSoriso sazogadoebrivi organizaciebis, xelisuflebis da samedicino

kvleva Ca




15

ebis xemZRvanelma pirebma da medikosebma. sul

moikiTxa Tbilisis cameti saavadmyofos (sul TbilisSi Tvrameti saavadmyofoa)

• jandacvis sferoSi dRemde ganxorcielebuli reformebis Sedegebis Sefaseba

sazogadoebis mosazrebebi axali saavadmyofoebis

efeqturi saqmianobis Sesaxeb grZelvadian perspeqtivaSi

buli reformebis Sefaseba

ofoebis raodenobisa da am saavadmyofoebSi arsebuli

amedicino personalis optimizaciisa da saavadmyofoebis saqmianobis xarisxis

urebis fizikuri da

is kvalifikaciis donis

masSi monawileoba miiRes saavadmyofo

ga

samocdaoTxi TanamSromeli. interviuebisa da Sexvedrebis dros yuradReba ZiriTadad Semdeg sakiTxebze

gamaxvilda:

samedicino sazogadoebis mier • samedicino sazogadoebis CarTulobis done “hospitaluri seqtoris

ganviTarebis generaluri gegmis” SemuSavebis procesSi • hospitaluri seqtoris reabilitaciis procesis Sinaarsisa da misi

mimdinareobis Sesaxeb informaciis miRebis da gavrcelebis ZiriTadi

wyaroebi • hospitaluri seqtoris privatizaciis mimdinareobis Sefaseba samedicino

sazogadoebis mier (am procesis Sesabamisoba dasaxul miznebTan,

gamWvirvalobis done, Sedegebis efeqturoba) • gamokiTxuli samedicino sazogadoebis mosazrebebi saxelmwifosa da

investorebs Soris dRemde gaformebuli xelSekrulebebis Sesaxeb • gamokiTxuli samedicino

• gamokiTxuli samedicino sazogadoebis mosazrebebi jandacvis sferos

regulirebis sakiTxebTan dakavSirebiT • gamokiTxuli samedicino sazogadoebis rekomendaciebi hospitaluri

seqtoris efeqturobis Semdgomi amaRlebisTvis

kvlevis Sedegebi 1996-2003 wlebSi ganxorciele samedicino personals gacnobierebuli aqvs meoradi jandacvis sistemis reformirebis

aucilebloba saavadmy

s

gaumjobesebisaTvis. isini miiCneven, rom miuxedavad saqarTveloSi dRemde

ganxorcielebuli reformebisa, 1991-2003 wlebSi jandacvis seqtoris

SesaZleblobebi didad ar gazrdila. am periodSi ganxorcielebuli reformebis

Sefasebis saSualo maCvenebelma optimizaciis, infrastruqturis ganviTarebisa da

samedicino aRWurvilobis ganaxlebis, samedicino momsax

geografiuli xelmisawvdomobisa da samedicino personal

TvalsazrisiT 2.6 qula Seadgina (maqsimaluri xuTi qulidan).




16

qturis ganaxlebis procesma: 66%-ma ganacxada, rom

ptimizaciis procesi ar ganxorcielebula, xolo 53% miiCnevs, rom

darebiT naklebad kritikuli iyo samedicino aRWurvilobis ganaxlebis

rocesisadmi: 47%-ma ganacxada, rom es procesi damakmayofilebeli iyo,

sawinaa d

yvelaz

geografiu is kvalifikaciam.

gamoki

samedicino

damakmayof iyo, sapirispiro azri gamoTqva31%-ma. rac Seexeba samedicino

person i

maRali, x cxril 1

Sefaseba

respodentebis mxridan yvelaze meti kritika daimsaxura saavadmyofoebis

optimizaciisa da infrastru

o

infrastruqturis ganaxleba Zalian dabal doneze ganxorcielda. samedicino

personali Se

p

Rm ego mosazreba daafiqsira gamokiTxulTA 27%-ma.

e dadebiTi Sefaseba miiRo samedicino momsaxurebis fizikurma da

lma xelmisawvdomobam da samedicino personal

Txuli saavadmyofoebis xelmZRvanelebisa da eqimebis 25%-ma ganacxada, rom

momsaxurebis fizikuri da geografiuli xelmisawvdomobis done

ilebeli

al s kvalifikacias, respodentTa 44% Tvlis, rom kvalifikaciis done iyo

olo 22% miiCnevs, rom es done dabali iyo.

i 1: jandacvis sferos reforma 1996-2003 wlebSi, samedicino sazogadoebis

66%

53%

47%

31%

22%

14%

17%

20%

30%

27%

8%

19%

27%

25%

44%

13%

11%

6%

14%

8%

30%

40%

60%

70%

80%

90%

100%

0%

10%

20%

optimizacia infrastruqturis

ganaxleba samedicino

teqnikis ganaxleba

fizikuri da

geografiuli

xelmisawvdomoba

samedicino

personalis

kvalifikacia

50%

uaryofiTi (1-2) neitraluri (3) pozitiuri (4-5) uaryi pasuxze




17

andacvis reformebis Sesaxeb respodentTa informirebulobis done 2003 wlamde da

-mde Semcirda, rodesac

spodentebs hkiTxes, Tu ramdenad informirebulni iyvenen post-revoluciuri

xrili 12: respondentTa informirebulobis done

j2003 wlis Semdeg

gamokiTxvis procesSi dasmuli iyo SekiTxvebi 2004 wlamde da 2004 wels

xelisuflebis cvlilebis Semdeg jandacvis seqtorSi mimdinare reformebis procesis

Taobaze samedicino personalis informirebulobis Taobaze. respodentTa 68.75%-ma

miuTiTa, rom isini informirebulni iyvnen 1996-2003 wlebSi qveyanaSi mimdinare

reformebis procesis Taobaze. aRniSnuli maCvenebeli 41%

re

reformebis procesis Taobaze. es ricxvi kidev ufro Semcirda, rodesac samedicino

personali saubrobda saavadmyofoebis privatizaciis procesTan dakavSirebiT

informirebulobis Taobaze.

gamokiTxvis Sedegebis Tanaxmad, privatizaciis procesis Sesaxeb saTanadod

informirebulia respodentTa mxolod 29.7%.

c

100%

69%

30%

41%

27%

66%

53%

5% 5% 6%

0%

20%

40%

60%

80%

informacia 1996-2003 wlebis reformebis Sesaxeb

informacia axali mTavrobisgeneraluri gegmis Sesaxeb

informacia mimdinare privatizaciis

Sesaxeb

diax

ra

uari pas.

informaciis ZiriTadi wyaroebi 2003 wlis Semdgomi samedicino reformebis Sesaxeb




18

respodentebs, romelTac miuTiTes, rom informirebulni iyvnen hospitalur

uxedavad imisa, rom respondentebis 36%-ma ganacxada, rom isini Sromis,

iis Taobaze, gamokiTxulTa didma

ravlesobam xazi gausva saministrosa da saavadmyofoebis TanamSromelTa Soris

ve aucileblobas xazi gaesva

wyaros media saSualebebi warmoadgenda.

im

seqtorSi mimdinare reformis Taobaze, “saerTaSoriso gamWvirvaloba saqarTvelom”

sTxova daesaxelebinaT informaciis ZiriTadi wyaroebi. aseT wyaroebad dasaxelda

media saSualebebi (58%), saavadmyofoebis administracia (58%) da Sromis,

janmrTelobisa da socialuri dacvis saministro (36%). privatizaciis procesis

Taobaze informaciis wyarod respodentebi iSviaTad asaxelebdnen ekonomikuri

ganviTarebis saministrosa da procesSi CarTul investorebs (informaciis wyarod

ekonomikuri ganviTarebis saministro daasaxela mxolod 12.5%-ma, xolo investorebi

–3%-ma).

mi

janmrTelobisa da socialuri dacvis saministrosagan sakmaris informacias iRebdnen

samedicino seqtorSi mimdinare privatizac

um

komunikaciis donis gazrdis aucileblobas. aseTi

samedicino reformis procesSi Cabmul sxva samTavrobo struqturebsa da

investorebTan mimarTebaSic.

samedicino personali aucileblad miiCnevs am procesSi Cabmul dainteresebul

pirebs Soris ufro xSiri Sexvedrebis gamarTvas. isini gansakuTrebiT

dainteresebulni arian tenderebSi monawile investorebTan SexvedriT, raTa miiRon

srulyofili informacia hospitalur seqtorTan dakavSirebiT investorTa miznebis

da am miznebis misaRwevad SemoTavazebuli meTodebisa da saSualebebis Taobaze.

aRsaniSnavia, rom saavadmyofoebis administraciam ufro dadebiTad upasuxa SekiTxvas

Sromis, janmrTelobisa da socialuri dacvis saministrosa da saavadmyofoebs Soris

privatizaciis Taobaze ganxorcielebuli komunikaciebis Taobaze (am kiTxvas

dadebiTad upasuxa gamokiTxul xelmZRvanel pirTa 77%-ma), vidre eqimebma (maTma

86%-ma uaryofiTi pasuxi daafiqsira), Tumca orive jgufi Tanabrad kritikuli iyo

ekonomikuri ganviTarebis saministrosTan da investorebTan arsebuli komunikaciis

SefasebaSi. saavadmyofoebis xelmZRvanelTa 82%-ma uaryofiTad Seafasa urTierToba

ekonomikuri ganviTarebis saministrosTan, 95%-ma – investorebTan.

personalis 90% iziarebda imave Sexedulebas ekonomikuri ganviTarebis saministros

Taobaze, xolo 98% – investorTa Taobaze. orive maTganisTvis informaciis ZiriTad




19

i

anxorcielebis mimdinareobis Sesaxeb

cxrili 13: informaciis ZiriTadi wyaroebi generaluri gegmisa da mis

g

cxrili 14: mecamete cxrilis gaSla

58% 58% 64%

88%

97%

60%

80%

100%

36%

13%

3%

0%

20%

40% 42% 42%

investorebi media

diax

ara

23%

76% 77%

14%18%

10%5%

64% 55%

77%

24% 23%

36% 45%

20%

40%

60%

80%

2%

86%82%

90%95% 98%100%

0%

administr. personali administer. personali administer. personali administer. personali administer. personali

saavadmyofos administracia

jandacvis saministro

ekonomikis saministro

investorebi media

diax ara

saavadmyofos

administracia jandacvis

saministro ekonomikis

saministro

dRemde Catarebuli Sexvedrebis ZiriTadi Tematika




20

),

da

ebze

adi

dRemde Catarda ramdenime Sexvedra Sromis, janmrTelobisa da socialuri dacvis

saministrosa da saavadmyofoebis personals Soris. gamokiTxuli samedicino

personalis mier mowodebuli informaciis Tanaxmad, es Sexvedrebi ZiriTadad exeboda:

hospitaluri seqtoris optimizacias (dasaxelda respodentTa 55%-is mier

samedicino saxelmZRvaneloebis gamoyenebas (dasaxelda respodentTa 45%-is

mier),

sawolebis raodenobis optimizacias (dasaxelda respodentTa 34%-is mier)

samedicino aRWurvilobis ganaxlebas (respodentTa 25%).

am SekiTxvaze pasuxis gacemis dros bevrma respodentma aRniSna, rom Sexvedr

gakeTebulma gancxadebebma da dapirebebma Semdgom qmedebebSi asaxva ar hpova.

cxrili 15: konsultaciebi samedicino sazogadoebasTan da Sexvedrebis ZiriT

Tematika

55%

34%

23%

16%

25%

45%

13%

31%

52%

41%

14% 14% 14% 14% 14% 14% 14%

%

%

%

saavadmyofoebis

optimizacia sawolebis

optimizacia personalis

optimizacia

infrastruqturis

ganaxleba teqnikis

ganaxleba

Utilization o

63%

70%

61%

73%

0%

20

40

60

80%

100%

f fiz. da geograf

xelmisawvd

iuli

omoba

diax ara uari




21

is ZiriTadi miznebi da amocanebi medicino personalis azriT

aerTaSoriso gamWvirvaloba saqarTvelom” respondentebs sTxova, daesaxelebinaT

maT

gamoki 58%-is azriT, mTavrobis umTavresi mizani hospitaluri seqtoris

opt i

– s t va, rom generaluri

gma ar uzrunvelyofs samedicino momsaxurebis fizikur da geografiul

besebis

saZleblobebze, xolo 58%-ma Tqva, rom gegma ar uzrunvelyofda hospitaluri

hospitaluri seqtris ganviTarebis generaluri gegmsa

imisTvis, rom gamoekvlia samedicino sazogadoebis damokidebuleba “hospitaluri

seqtoris ganviTarebis generaluri gegmis” miznebis da maTi ganxorcielebis mimarT,

“s

i azriT am procesSi mTavrobisTvis yvelaze prioritetuli sakiTxebi.

TxulTa

im zaciaa; 52% is azriT – samedicino personalis optimizacia; 50%-is azriT ki

eq orSi kerZo investiciebis mozidva. amave dros, 73%-ma Tq

ge

xelmisawvdomobas; 63%-ma aRniSna, rom is ar emsaxureba sawolebis raodenobis

optimizacias; 61%-ma eWvi gamoTqva am meTodiT samedicino teqnikis gaumjo

Se

seqtoris infrastruqturis ganaxlebas. cxrili 16: samedicino sazogadoebis mosazrebebi generaluri gegmis miznebis Sesaxeb

58%

34%

52% 50%

39% 36% 39%

23%

38%

63%

45% 47%

58%61%

58%

73%

5% 3% 3% 3% 3% 3% 3% 3%

0%

20%

40%

60%

80%

100%

saavadmyofoebis optimizacia

sawolebis optimizacia

samedicino

personalis

optimizacia

kerZo

investiciebis

gazrda

infrastruqturisba

teqnikis gaumjobeseba

momsaxurebis

xarisxis

amaRleba

fiz. da

geograifiuli

xelmisawvd. uzrunvelyofa

gaumjobese

diax ara uari




22

aspeqtebi

elaze problemur sakiTxad respondentebma tenderebis kriteriumebi daasaxeles.

amWvirvaloba saqarTvelom” dasva Semdegi SekiTxva: `Tqveni informaciiT, ra

deba gamarjvebuli investorebis SerCeva?” Sedegebi

privatizaciis procesis Sefaseba respodentTa mier: misi miznebi, gamWvirvaloba, efeqturoba da samarTlebrivi zogadad, sxvadasxva aspeqtebis gaTvaliswinebiT, privatizaciis procesis

mimdinareoba, dadebiTad gamokiTxulTa mxolod 18%-ma Seafasa. 66%-is Sefaseba

mkveTrad negatiuri iyo.

yv

maTi 80% Tvlis, rom dRes gamoyenebuli kriteriumebi araefeqturia. am mxriv, 75%-

iT meore adgilze gavida procesis arasakmarisi gamWvirvaloba. iuridiuli

procedurebis gaumarTaoba uaryofiTad Seafasa gamokiTxulTA 66%-ma. SedarebiT

privatizaciis miznebis mimarT damokidebuleba ufro dadebiTi iyo.

cxrili 17: hospitaluri seqtoris privatizaciis procesis Sefaseba samedicino

sazogadoebis mier

100%

39%

13% 6%

16%18%

44%

75%

80%

67% 66%

17% 13% 14%

17%15%

0%

20%

40%

60%

80%

miznebis

efeqturoba

procesis

gamWvirvaloba

kriteriumebis

efeqturoba

procesis samarTlebrivi

mxare

yvela

aspeqti

respodentTa informirebuloba SerCevis kriteriumebis Sesaxeb saavadmyofoebis privatizaciis procesSi

hospitaluri seqtoris privatizaciis procesSi satendero kriteriumebis Sesaxeb

respodentTa informirebulobis donis Sefasebis mizniT “saerTaSoriso

dadeb. uaryof. uari

g

kriteriumebis safuZvelze x




23

rTa mier warmodgenil sabanko garantiebs

qcevda; 30%-ma aRniSna, rom mTavari kriteriumi investorebis mier SeTavazebuli

mier saavadmyofoebis mSeneblobis, aRWurvisa da

nqcionirebis detaluri detaluri programebis/gegmebis warmodgenas.

m

zriT, umjobesi iqneboda, Tu gamarjvebuli investorebis SerCeva moxdeboda: (1)

marTvis sistema, samedicino personalis kvalifikaciis

Txovnebi, fasebis regulirebis sqema, momsaxurebis standartebi da a.S. (am

mxari dauWira respondentTa 55%-ma.

Semdegnairad gamoiyureba: gamokiTxulTa 50%-ma Tqva, rom mTavroba yvelaze did

yuradRebas tenderSi monawile investo

a

vadebi iyo; 70%-is azriT, xelisufleba araviTar yuradRebas ar aqcevda investorTa

gamocidlebas jandacvis sferoSi; 59% ki Tqva, rom xelisufleba mniSvnelovnad ar

miiCnevda investorebis

fu

cxrili 18: respondentebis informirebuloba investorebis SerCevis kriteriumebis

Sesaxeb

100%

70%

80%

9% 17%

50%

30%

20%

63%

30%

50%

59%

20% 20% 20% 20% 20%

0%

20%

40%

60%

investoris

gamocdileba

seqtorSi

SeTavazebuli

sawolebis

raodenoba

finansuri

garantiebi

mSeneblobis da

aRWurvis vadebi

saavadmyofos

ganviTarebis

detaluri

gegma

samedicino personalis mier SemoTavazebuli kriteriumebi

mTavrobis mier gansazRvruli kriteriumebi mniSvnelovnad gansxvavdeba i

kriteriumebisgan, romlebic samedicino sazogadoebas miaCnia mizanSewonilad. maTi

a

investorebis mier wardgenili detaluri programebis safuZvelze, sadac gawerili

iqneboda saavadmyofoebis

mo

kriteriums mxars uWers gamokiTxulTa 80%); (2) investorebis samedicino seqtorSi

gamocdilebis safuZvelze (72%) da (3) fasebis xelmisawvdomobis uzrunvelyofis

safuZvelze (63%). investorebis mier sabanko garantiebis warmodgenis moTxovnas

diax ara uari

saavadmyofoebis aSenebisa da aRWurvis vadebis erT-erT mTavar kriteriumad

ganxilvas ar daeTanxma gamokiTxulTa 53%, xolo sawolebis raodenobaze aqcentis

gakeTebas – 75%-ma. cxrili 19: ra kriteriumebis mixedviT unda moxdes gamarjvebuli investoris

SerCeva

100%

72%

23%

55% 45%

55%

63%

47%

27%

75%

44% 53%

19%

44%

36%

52%

2% 2% 2% 2% 2% 2% 2% 2%0%

20%

40%

60%

investoris

gamocdileba

seqtorSi

SeTavazebuli

sawolebis

raodenoba

investoris

finansuri

garantiebi

saavadmyofos

mSeneblobis da

aRWurvis

vadebi

saavadmyofos

ganviTarebis

detaluri

programa

investoris

mier

SeTavazebuli

teqnika

samedicino

momsaxurebis

xelmisawvdomoba

samedicino

personalis

kvalifikaciis

done

80%80%




24

rT-erTi mTavari kriteriumi, romlis mixedviTac mTavroba tenderebSi gamarjvebul

Tavdapirvelad mTavrobas

adawyvetili hqonda, rom mSeneblobebis procesi or welSi daesrulebina, Tumca

privatizaciis procesisa da saavadmyofoebis mSeneblobis vadebi

e

investorebs arCevs, mSeneblobis dasrulebis vadebia.

g

mogvianebiT, saerTaSoriso organizaciebis rekomendaciebis gaTvaliswinebiT, es vada

sam wlamde gazarda.

evropuli standartebiT axali saavadmyofos aSenebasa da srulad aRWurvas xuTidan

eqvs wlamde esaWiroeba. miuxedavad amisa, gamokiTxulTa 34%-ma Tqva, rom mTavrobis

mier am etapze dadgenili vadebi damakmayofilebelia, an piriqiT – zedmetad grZelia.

sapirispiro azri daafiqsira respondentTa 30%-ma. 44%-ma ki Tqva, rom

daCqarebulia ara imdenada mSeneblobis, ramdenadac privatizaciis vadebi.

diax ara uari




25

mniSvnelovania. maT ufro metad ainteresebT

, Tu rogor ganviTardeba procesebi privatizaciis da mSeneblobebis dasrulebis

rili 20: privatizaciis vadebi

is mdgradoba da investorTa valdebuleba grZelvadiani momsaxurebis uzrunvelyofis Taobaze

tendero xelSekrulebebis pirobebis Tanaxmad, investorebma axlad aSenebuli

s gaweva? dRemde Catarebuli tenderebis did nawilSi

piratesoba developerul da farmacevtul kompaniebs mianiWa.

miuxedavad amisa, gamokiTxuli samedicino sazogadoebis azriT, privatizaciisa da

mSeneblobis vadebi, zogadad, naklebad

is

Semdeg, ramdenad uzrunvelyofili iqneba samedicino momsaxurebis xarisxi da

xelmisawvdomoba. cx

50%

44%

30%

27% 25%

9%

19%20%

27%

0%

10%

20%

30%

40%

privatizaciis procesi saavadmyofoebis mSeneblobis da

aRWurvis procesi

SezRuduli

sakmarisi

xangrZlivi

uari pasux.

axali saavadmyofoebsamedicino

sa

(ganaxlebuli) saavadmyofoebi minimum Svidi wlis ganmavlobaSi unda amuSavon. am

vadis gasvlis Semdeg maT ufleba aqvT, saavadmyofoebi nebismieri sxva tipis

dawesebulebad gadaaakeTon. am sakiTxTan mimarTebaSi Cndeba ori kiTxva: (1) ra

motivacia eqnebaT investorebs, rom Svidwliani vadis gasvlis Semdeg gaagrZelon

samedicino momsaxurebi

xelisuflebam u

developerul kompaniebs, bunebrivia, samedicino sferoSi gamocdileba naklebad aqvT

da am etapze rTuli saTqmelia, Tu ramdenad didia maTi daintereseba am sferoTi

grZelvadian perspeqtivaSi. mTavroba varaudobs, rom aRniSnuli sakiTxi sabazro




26

n biznesad

ebaT saavadmyofoebis gamarTul, momgebian biznesad formireba.

2) dResdReobiT ucnobia, Tu rogor moxdeba zaralis anazRaureba da vin aiRebs

iani samedicino momsaxurebiT uzrunvelyofis

s

ekonomikis principebidan gamomdinare daregulirdeba, rom maRali xarisxis

saavadmyofoebis aSenebisa da aRWurvis Semdeg, es saavadmyofoebi momgebia

gadaiqceva da Sesabamisad, investorebi Tavadve iqnebian dainteresebulebi, rom Svidi

wlis Semdegac SeunarCunon maT profili. am SemTxvevaSi gasaTvaliswinebelia is

garemoeba, rom Tu xelisufleba jandacvis sferoSi mimdinare procesebs sworad ar

dagegmavs da am sferos regulirebas saTanadod ar moaxdens, investorebs,

savaraudod, gauWird

(

saqarTvelos mosaxleobis xarisx

valdebulebas aseT SemTxvevaSi.

“saerTaSoriso gamWvirvaloba saqarTvelos” mier Catarebuli gamokiTxvis monawileTa

didi nawilis dainteresebis sagans swored is warmoadgens, Tu rogor ganviTardeba

procesebi privatizaciis dasrulebis da Svidwliani vadis gasvlis Semdeg. maT

aeWvebT saavadmyofoebis momgebianoba, gansakuTrebiT regionebSi, sadac axali

saavadmyofoebi, generaluri gegmis Tanaxmad, mxolod 15-25 sawoliT iqneba

aRWurvili (regionul centrebSi sawolebis raodenoba 150-iT ganisazRvreba). garda

amisa, respondentebis azriT, investorebi, mogebis gazrdis mizniT, aqcents ufro

momgebian samedicino momsaxureobebze gaamaxvileben da es nel-nela Seamcireb

SedarebiT naklebadmomgebiani, magram sasicocxlo mniSvnelobis momsaxureobebis wils

(aq igulisxmeba iseTi daavadebebi, rogoricaa qronikuli kardiovaskulari,

onkologiuri daavadebebi, fsiqikur problemebTan dakavSirebuli daavadebebi da a.S.),

rac saboloo jamSi, am saxis momsaxureobebis sruli gaqrobiTac SeiZleba

dasruldes. cxrili 21: naklebadmomgebiani daavadebebis mkurnalobis SesaZleblobebis Semcireba

81%

11%

8%

diax ara uari

samedicino momsaxurebis xelmisawvdomoba privatizaciis procesis Semdeg

Tbilissa da regionebSi saxelmwifos sakuTrebaSi arsebuli saavadmyofoebis kerZo

seqtorisaTvis gadacemasTan dakavSirebiT kvlevis respondentebma erT-erT problemad

privatizaciis Semdeg fasebis savaraudo zrda daasaxeles. es varaudi gamokiTxulTa

90%-ma gamoTqva.

cxrili 22: privatizaciis Sedegad fasebis savaraudo zrda

5%5%

diax

ara

uari

90%

respodentebma gansxvavebuli Sexedulebebi imis gamoTqves Taobaze, Tu rogor unda

iqnas Tavidan acilebuli privatizaciis Sedegad samedicino momsaxurebaze fasebis

zrda. kerZod:




27

socialurad daucveli jgufebis samedicino momsaxurebis dafinansebis

gazrdiT unda dabalansdes, Tumca am SemTxvevaSi problemas is warmoadgens,

rom am tipis miznobrivi dafinanseba socialurad daucvel fenebs problemebs

garkveulwilad namdvilad mougvarebs, magram is, savaraudod, ufro rTul

mdgomareobaSi Caayenebs sazogadoebis im nawils, romelic socialurad

daucvelTa kategoriaSi xvdeba, magram arc imis finansuri SesaZlebloba aqvs,

rom gaZvirebuli samedicino momsaxureba sakuTari saxsrebiT daafinansos.

respodentTa 67%-ma aRniSna, rom saxelmwifom unda SemoiRos saxelmwifo

dazRveva.

respodentTa 30% miiCnevs, rom axali saavadmyofoebis mmarTveli jgufebi

(axali mflobelebi) valdebulebi unda iyvnen iseTi ekonomikuri gegmebi da

respodentTa 75%-ma Tqva, rom gazrdili fasebi saxelmwifos mier




28

asebis

respo

e kargad sabazro

sic aRniSnes, rom

nemde

s. cxrili 2

samedicino momsaxurebis xarisxis dacvis meqanizmebi mTels msoflioSi samedicino momsaxurebis gawevis umniSvnelovanes elementad

miCneulia saxelmwifos monawileoba samedicino seqtoris regulirebaSi da am

ukanasknelis mier “zedamxedvelis rolis” Sesruleba13. zogadad, jandacvis seqtori

gaTvlebi warmoadginon, rom maqsimalurad Tavidan iqnas acilebuli f

zrda.

dentTa 16%-ma ganacxada, rom xelisuflebam aranairi monawileoba ar

unda miiRos am procesSi. maTi azriT, es sistema yvelaz

ekonomikis principebis safuZvelze daregulirdeba.

5%-is azriT, problemis gadaWris saukeTeso meqanizmi savaldebulo da kerZo

dazRvevebis sistemebis SeTanxmeba iqneboda, Tumca maT i

dRevandeli mdgomareobiT saqarTveloSi sadazRvevo bazari ar aris im do

ganviTarebuli, rom dazRvevaze gazrdili moTxovna srulad daakmayofilo

3: gazrdili fasebis daregulirebis meqanizmebi

75% 67%

77%

63% 60%

80%

16%

30%

17% 25%

8% 8% 8% 8%

0%

20%

40%

100%

socialurad daucveli

fenebis dafinanseba gaizardos

dawesdes savaldebulo

samedicino dazRveva

xelisufleba saerTod

ar unda Caerios

saavadmyofos administraciam

daareguliros fasebi

13 sajaro da kerZo politika jandacvis sferoSi: institucionaluri ekonomika da organizaciuli

Teoria. s. Prekeri da hardingi, aprili.

diax ara uari




29

is erT-erTi yvelaze metad regulirebuli seqtorTagani yvela qveyanaSi, maT

Sor

gamoki

aRWur

person

momsax

gausva

medikam ino

aRWurvilobis licenzirebis ideas, 73% daeTanxma samedicino personalis

ser f

dawesebulebebis akreditaciis aucilebloba. rac yvelaze mniSvnelovania,

aavadmyofoebis privatizaciis programa ar Seicavs araviTar debulebas axali

daw e

monito

umravl

dawesebuli teqnikuri standartebi ar aris adeqvaturi maRali xarisxis samedicino

momsaxurebis gasawevad. xelisuflebis gancxadebis Tanaxmad, amJamad jandacvis

seq r cxril zmebi

ar

is ganviTarebul qveynebSic.

Txuli samedicino personalis azriT, saavadmyofoTa licenzireba, samedicino

viloba da medikamentebi, akreditirebis strategiebTan da samedicino

alis sertificirebasTan erTad, warmoadgens kvalificiuri samedicino

urebis gawevisaTvis aucilebel elementebs. gamokiTxulTa 93.75%-ma xazi

samedicino momsaxurebis licenzirebis aucileblobas, 81.3%-ma gamoyo

entebis licenzirebis saWiroebas, 78%-ma mxari dauWira samedic

ti icirebis aucileblobas, xolo 66%-ma mniSnvelovnad miiCnia samedicino

s

es bulebebis mier gaweuli momsaxurebis sxvadasxva tipebis regulirebis an

ringis Taobaze. imavdroulad, rogorc es aRiniSna samedicino personalis

esobis mier, samedicino aRWurvilobaze investorebisaTvis am etapze

to is maregulirebeli politika gadaxedvis procesSia.

i 24: samedicino momsaxurebis xarisxis dacvis meqani

94%

78% 81%

73%

%

66%

5% 9% 9%

17%13%

2%

13%9%

17% 14%

0%

20%

40%

80%

100

samedicino momsaxurebis

licenzireba teqnikis

licenzireba

preparatebis

licenzireba

samedicino dawesebulebebis

akreditacia samedicino personalis

sertifiireba

60%

diax ara uari




30

CarTulobis uzrunvelyofa da procesis gamWvirvalobis gazrda

acia janmrTelobis sferos reformis erT-erTi

”saerTaSoriso gamWvirvaloba saqarTvelom” agreTve sTxova respodentebs gamoexataT

TavianTi mosazrebebi imaze, Tu ra roli unda Seasrulos xelisuflebam

saqarTveloSi jandacvis seqtoris regulirebis procesSi. respodentTa 31% miiCnevs,

rom saqarTvelos xelisuflebam unda ikisros pasuxismgebloba jandacvis sistemis

funqcionirebaze. maTi azriT, saxelmwifom unda gansazRvros saavadmyofos

resursebTan (fizikuri kapitali), samedicino personalTan (adamianuri resursi) da

samecniero midgomasTan (ineleqtualuri kapitali) dakavSirebiT standartebi da

saxelmZRvanelo principebi/direqtivebi. respodentTa 68.75% miiCnevs, rom xsenebuli

funqcia unda gadaeces am sferoSi profesiul asociaciebs. gamokiTxulTa 14%-ma ki

miuTiTa, rom standartebi da saxelmZRvanelo principebi unda SemuSavdes orive

subieqtis monawileobiT.

cxrili 25: maregulirebeli struqturebi

daskvnebi da rekomendaciebi hospitaluri seqtoris reabilitaciis procesSi mniSvnelovan monawileebis

hospitaluri seqtoris privatiz

31% 27%

20%

40%

69%

14%

63%

86%

80%

100%

60%

6% 5%

0%0%

Sesabamisi samTavrobo uwyeba profesiuli asociaciebi sxva

diax ara uari




31

eriumebi sworad iqnas

emuSavebuli, Sesabamisad investorebis SerCevac sworad ganxorcieldes da

seqtoris reformis

T, arsebobs eWvebi imis Taobaze, moaxerxeben Tu ara

enebuli saavadmyofoebi mogebis miRebas. aRniSnuli sakiTxi metad SemaSfoTebelia

wlis Semdeg mflobelebs aRar eqnebaT

mniSvnelovani nawilia. Sesabamisad, saxelmwifo am process ar unda uyurebdes

rogorc mxolod ekonomikur process, romlis administrirebaSic monawileobas

mxolod ekonomikuri ganviTarebis saministro, ekonomikur procesebze pasuxismgebeli

uwyeba, iRebs. masSi aqtiurad unda iyos CarTuli Sromis, janmrTelobisa da

socialuri dacvis saministro da samedicino sazogadoeba, rac Seqmnis imis

aucilebel winapirobebs, rom investorebis SerCevis krit

S

privatizaciis procesma is Sedegebi gamoiRos, rac hospitaluri

generalur gegmaSia gawerili.

rogorc minimum, samedicino sferos warmomadgenlebs unda mieceT imis saSualeba,

rom Sexvdnen tenderebSi monawile investorebs, gaecnon maT winadadebs, maT mier

warmodgenil proeqtebs da ekonomikuri ganviTarebisa da Sromis, janmrTelobisa da

socialuri dacvis saministroebs gaacnon TavianTi mosazrebebi warmodgenili

proeqtebis Zlier da sust mxareebTan mimarTebaSi. gamarjvebuli investorebis SerCevis kriteriumebis daxvewa saavadmyofoebis privatizaciis procesSi aucilebelia ufro naTeli kriteriumebis

arseboba da isini unda Camoyalibdes jandacvis saministrosa da sxva dainteresebuli

pirebis monawileobiT. meti yuradReba unda daeTmos am seqtorSi investorTa

gamocdilebas da saavadmyofoebis mSeneblobis, ganviTarebisa da menejmentis

SemoTavazebul gegmebs. respodentTa 80%-ma gamoxata SeSfoTeba SerCeul investorTa

mier am seqtorSi gamocdilebis arqonasa da warmodgenil winadadebebSi detalebis

simciresTan dakavSirebiT, romlebic ZiriTadad exeboda iseT teqnikur detalebs,

rogorebicaa gamoyenebadi sawolebis raodenoba, samSeneblo procesis dasrulebis

vadebi da a.S.

aucilebelia meti Tanmimdevruloba dadgenili kriteriumebis gamoyenebaSi, raTa

uzrunvelyofil iqnas privatizaciis procesis meti efeqturoba, gamWvirvaloba da

samarTlianoba. rogorc aRiniSna am moxsenebaSi, kriteriumebi viTardeboda

privatizaciis mimdinareobis procesSi da zogierT SemTxvevebSi jer kidev ar iyo

naTlad gansazRvruli konkretuli saprivatizacio garigebebis dawyebis

momentisaTvis.

unda moxdes regionaluri saavadmyofoebis momgebianobis sakiTxis gadasinjva. amJamad,

sawolebis mcire raodenobisa da regionebSi dRes arsebuli socialur-ekonomikuri

pirobebis gaTvaliswinebi

xs

im faqtis gaTvaliswinebiT, rom Svidi




32

saavadmyofoebis funqcionirebis SenarCunebis valdebuleba. respodentebi SiSoben, rom

Svidi wlis Semdeg mogebis ararsebobis SemTxvevaSi mflobelebi gardaqmnian

saavadmyofoebs ufro momgebian biznesebad da Sesabamisad, mosaxleobis mTel rig

segmentebs datoveben samedicino momsaxurebis gareSe.

zemoxsenebulidan gamomdinare aucilebelia saavadmyofoebis Svidwliani

funqcionirebis pirobis gadasinjva. SeinarCunebs Tu ara axali infrastruqtura

jandacvasTan dakavSirebul funqcias grZelvadian perspeqtivaSi, mniSvnelovnad aris

damokidebuli kerZo investorebis xarisxze. swored amitom gamoiTqva SeSfoTeba

jandacvis seqtorSi investorTa gamocdilebis xarisxTan dakavSirebiT, agreTve

ekonomikuri ganviTarebis saministrosaTvis wardgenil gegmebSi saWiro detalebisa

da xsenebuli seqtoris regulirebis TvalsazrisiT saxelmwifos amJamindeli

SesaZleblobisa da survilis simciris Sesaxeb. pasuxismgebel struqturebs Soris da am struqturebis sazogadoebasTan urTierTobebis gaumjobeseba miuxedavad imisa, rom samedicino sazogadoebis warmomadgenlebi ZiriTadad dadebiTad

afaseben hospitaluri seqtoris reformis miznebs, maTi damokidebuleba am miznebis

anxorcielebis gzebis da procesis mimdinareobis mimarT ufro uaryofiTia. rogorc

amokiTxviT gairkva, samedicino sazogadoeba arasakmarisad aris informirebuli

ciis mimdinareobis Sesaxeb (gamokiTxulTa mxolod

0%-ma Tqva, rom privatizaciis Sesaxeb garkveul informacias flobda).

socialuri dacvis

aministroebs Soris urTierTobis gaumarTaobis gamo. privatizaciis Sesaxeb

omis, janmrTelobisa da socialuri dacvis saministrosa da hospitaluri

g

g

hospitaluri seqtoris privatiza

3

saavadmyofoebis xelmZRvanelebma da TanamSromlebma ukmayofileba gamoTqves maTsa da

ekonomikuri ganviTarebis da Sromis, janmrTelobisa da

s

informaciis ZiriTad wyarod maTma umravlesobam (58%-ma) media saSualebebi

daasaxela maSin, roca am procesis Sesaxeb mediaSi gavrcelebuli informacia,

Cveulebriv, zedapiruli da araTanmimdevrulia.

amis gaTvaliswinebiT aucilebelia, rom samedicino sferos warmomadgenlebsa da

hospitaluri seqtoris reabilitaciis procesSi CarTul saxelisuflebo uwyebebs

Soris ormxrivi urTierToba ufro ganmtkicdes. es xels Seuwyobs am procesis

gamWvivalobis gazrdas, rac misi xarisxis amaRlebazec dadebiTad imoqmedebs (dRes

gamokiTxulTa 75% Tvlis, rom reabilitaciis procesi aragamWvirvalea).

Sr

seqtoris warmomadgenlebs Soris urTierTobis ganmtkiceba Tavis TavSi ara mxolod

ormxrivi Sexvedrebisa da konsultaciebis gamarTvas, aramed Sexvedrebs Soris

aqtiur urTierTTanamSromlobasac unda moicavdes. Sexvedrebze ganxilul sakiTxebs




33

as gegmavs is samedicino

ersonalis mier wamoweuli problemebis gadasaWrelad da rogor mimdinareobs am

“saerTaSoriso gamWvirvaloba saqarTvelos” kvlevis

ebSi ramdenime Sexvedra

amarTa maTTan. am Sexvedrebze araerTi mniSvnelovani sakiTxi iqna ganxiluli da

liberaluri saxelmwifo politikis qveynebSic. jandacvis seqtori

rdapir kavSirSia adamianebis sicocxlesTan da Sesabamisad, gansakuTrebiT

gulireba mniSvnelovania imisTvisac, rom SenarCundes samedicino momsaxurebis

(a) socialurad daucveli fenebis samedicino momsaxurebis programebis

Rvevo bazari jerjerobiT im doneze

da miRweul SeTanxmebebs gagrZeleba unda mohyves. saministrom periodulad unda

gaavrcelos informacia imis Sesaxeb, Tu ra nabijebis gadadgm

p

nabijebis ganxorcieleba.

respondentebis umravlesobis TqmiT, saministrom wina wl

g

saministros mxridan bevri dapirebac gakeTda, Tumca dapirebebi dapirebebadve darCa.

saboloo jamSi Sexvedrebma formaluri saxe miiRo da nel-nela isini saerTod

Sewyda.

jandacvis sferos efeqturi regulireba jandacvis sfero mTel msoflioSi yvelaze maRali regulirebiT gamoirCeva, maT

Soris, yvelaze

pi

mniSvnelovania, rom am seqtorSi xarisxis regulirebis da kontrolis efeqturi

meqanizmebi arsebobdes (sxvadasxva saxis standartebis da minimaluri moTxovnebis

dawesebis da maT Sesrulebaze kontrolis ganxorcielebis saxiT). xelisuflebis

pirdapiri movaleobaa, rom qveyanaSi arsebobdes efeqturi, xarisxiani da

xelmisawvdomi jandacvis sistema.

re

naklebadmomgebiani, magram sasicocxlo mniSvnelobis saxeobebi da bazari mxolod

yvelaze Semosavlianma momsaxureobebma ar gadafaros.

xelisuflebas garkveuli pasuxismgebloba imazec ekisreba, rom jandacvis sferos

mTlianad kerZo seqtorSi gadasvlam fasebis imgvari zrda ar gamoiwvios, rom is

mosaxleobis didi nawilisTvis xelmiuwvdomeli ar gaxdes. “saerTaSoriso

gamWvirvaloba saqarTvelos” mier Catarebuli kvlevis farglebSi gamokiTxulma

respondentebma am problemis gadaWris ramdenime gza daasaxeles:

gazrda, Tumca am SemTxvevaSi mniSvnelovania imis gaTvaliswineba, Tu ra

gavlenas iqoniebs es midgoma saSualo fenaze (saqarTvelos mosaxleobis

daaxloebiT 40%-ze), romelic socialurad daucvelTa kategorias ar

ganekuTvneba, magram arc imis finansuri resursi aqvs, rom ZviradRirebuli

samedicino momsaxureba miiRos;

(b) savaldebulo dazRvevis SemoReba, Tumca am SemTxvevaSi problemas is

warmoadgens, rom saqarTveloSo sadaz




34

ar aris ganviTarebuli, rom dazRvevaze ramdenjerme gazrdili moTxovna

srulad daakmayofilos;

waxaliseba da paralelurad savaldebulo dazRvevis

sistemis gamarTva;

ebiT gaTvaliswinebuli pirobebis

rRvevis SemTxvevaSi amoqmeddeba.

Wvirvaloba

runvelyofili.

(g) kerZo dazRvevis

(d) investorebis SerCevis dros yuradRebis gamaxvileba imaze, Tu ramdenad

uzrunvelyofen isini axal saavadmyofoebSi fasebis xelmisawvdomobas. privatizaciis Sedegebis analizi da xelSekrulebebiT gansazRvruli pirobebis dacva saWiroa, rom privatizaciis xelSekrulebebSi ufro detalurad gaiweros mxareTa

valdebulebebi, Sesrulebuli samuSaos Sefasebis kriteriumebi (magaliTad, sawolebis

datvirTvis maCvenebeli, pacientTa gamtarianoba, finansuri xelmisawvdomoba,

infrastruqtura da teqnikuri aRWurva, samedicino personalis kvalifikaciis done

da a.S.) da sanqciebi, romlebic xelSekrul

da

aseve mniSvnelovania, rom ganisazRvros, Tu (a) rogor ganaxorcielebs saxelmwifo

xelSekrulebebis Sesrulebis monitorings, (b) romeli saxelisuflebo da

arasaxelisuflebo struqturebi iqnebian CarTulebi am procesSi, (g) rogori iqneba

TiToeuli maTganis roli da (d) rogor iqneba procesis gam

uz

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