Description
In the Together for Health program, primary care physicians provide structured and coordinated care for chronic noncommunicable diseases (NCDs). This includes personalized treatment plans, enhanced secondary prevention, and quicker access to specialists. Care covers NCDs like CVD (hypertension and ischemic heart disease), diabetes, COPD, asthma, osteoporosis, prostatic disease, and depression. Physicians conduct regular control visits to assess and adjust care plans, supported by trained registered nurses. Care follows guidelines set by specialist societies, with specialist consultations available via referrals or remote means.Program launch date
2015Responsible entity
National Health FundAvailable results and quality metrics
Data on individual CVD endpoints are unavailable, and data on CVD risk factors management are incomplete.Limitations / comments
The programme is implemented in most family medicine/GP clinics in Slovenia, but implementation and patient coverage vary due to a shortage of primary care physicians. Timely specialist consultations are often difficult to provide. Reliable data on the programme"s effectiveness and efficiency is lacking due to unsystematic data collection. However, the upcoming introduction of EHRs is expected to improve the situation.