Interim Manager of Gura Humorului Town Hospital, Ciprian Gheorghe IANOVICI, at FERM 2025: “Without the support of small hospitals, the balance of the healthcare system is deeply threatened”
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REGIONAL ECONOMIC FORUM MOLDOVA 2025
19th Edition – Vatra Dornei, July 9–13, 2025
Thematic Panel:
Health and Medical Services in the Moldova Region
Speaker:
Ciprian Gheorghe Ianovici, interim manager of Gura Humorului Town Hospital
Topic of the intervention:
„The small hospital between emergency and prevention”
Ciprian Gheorghe Ianovici, interim manager of Gura Humorului Town Hospital, draws attention to the enormous pressure faced by small hospitals and the urgent need for systemic reform. He presented the challenges of small hospitals caught between the need to manage emergencies and their insufficiently supported role in prevention.
Disproportionate pressure on small hospitals: between emergency and lack of prevention
In his intervention, Ciprian Gheorghe Ianovici raised several essential questions regarding the future of small hospitals: how emergency medicine can be managed in such units, how to relieve emergency rooms and Emergency Reception Units, and how to ensure continuity of medical care under conditions of acute shortage of personnel and resources.
Gura Humorului Town Hospital, which he leads, serves more than 60,000 inhabitants and recorded in 2024 approximately 80,000 medical presentations, of which 19,000 at the emergency room. In the absence of functional permanent centers and an integrated prevention infrastructure, small hospitals effectively become first intervention points, assuming a role that exceeds their real operational capacity.
“How do we handle emergency medicine in small hospitals? How do we relieve emergency rooms and ER units? How do we ensure continuity of medical care in these units with reduced staff and limited resources?” asked Ciprian Gheorghe Ianovici.
Reforming access to medical services – an imminent risk of emergency overcrowding
A central point of the intervention focused on the implications of the new regulation restricting access for uninsured persons to basic medical services. Ciprian Gheorghe Ianovici warned that this measure could lead to a significant increase in presentations to emergency reception units, generating additional pressure on the system:
“The uninsured will have nowhere else to go. They will come directly to the emergency room because it is free there. And that means more stress for the staff, more resources wasted, and a higher risk for real emergency cases.”
Impact of uncontrolled access on the Emergency Reception Unit
The chief physician of the Emergency Reception Unit at Botoșani County Hospital, Ramona Guraliuc, highlighted the negative effects of restricting controlled access to medical services, which risks turning the ER into a gathering point for patients without real emergencies:
“Any measure that removes controlled access to health will push patients into the ER. We will have even more non-urgent cases treated as emergencies. This seriously affects the quality of medical care.”
Additionally, Dr. Ramona Guraliuc drew attention to the phenomenon of abusive 112 emergency calls, which amplify pressure on emergency services:
“People don’t know what an emergency is. Calling an ambulance for minor pain has become a frequent practice. We must intervene educationally, not only logistically.”
Human resource challenges in small hospitals
Valentin Ioan Stan, manager of Vatra Dornei Municipal Hospital, emphasized the pressing issue of the shortage and demotivation of medical staff in small units, mainly caused by inadequate salary conditions:
“On-call shifts are paid below the appropriate level compared to normal working hours. This situation is unacceptable and causes doctors to migrate away from small hospitals, where responsibility is high, but financial motivation is insufficient.”
The manager called for an urgent revision of the salary legislation in the health sector, stressing that the current regulatory framework, in force since 2018, no longer reflects the realities and current needs of the system.
Health education, an essential pillar in disease prevention
Dr. Carmen Dorobăț, a recognized infectious disease specialist, pointed out the major deficit of medical education among the population:
“The lack of health education in schools leads to inappropriate behavior in prevention and individual protection, which causes the healthcare system to be overcrowded with cases that could be avoided.”
Dr. Carmen Dorobăț advocated for the implementation of an integrated strategy focused on prevention and systematic screening, instead of a model exclusively centered on treating emergencies and repairing effects.
Advanced solutions proposed during the panel
- Development and expansion of permanent centers, with priority in rural and tourist areas, to decentralize emergency medical services;
- Implementation of integrated telemedicine as effective support for small hospitals, facilitating rapid access to specialized consultations;
- Introduction of a digitalized triage and scheduling system for emergency rooms, aimed at optimizing patient flow and reducing overcrowding;
- Development and implementation of a national health education strategy in schools, aiming at prevention and population accountability;
- Revision and updating of the legislation regarding on-call shift remuneration to increase motivation and retention of medical personnel in small units.
Conclusions:
The intervention of manager Ciprian Gheorghe Ianovici brought to the forefront the complex realities and challenges faced by small hospitals in the region. Although operating with limited resources and reduced staff, these medical units play a fundamental role in ensuring continuity and accessibility of healthcare services for local communities.
Small hospitals actually represent the backbone of the regional healthcare network, often being the first point of contact for hundreds of thousands of patients. To support their efficiency and sustainability, an integrated approach is imperative, which should include infrastructure development, process digitalization, strengthening human resources, and integration into a coherent system of prevention and medical intervention.
Only through these coordinated measures can the degradation of the regional health system be prevented and quality medical services, adapted to the real needs of the population, be provided.
Thus, the voice and experience of a small but essential hospital become a landmark for necessary health reforms, decisively contributing to the shaping of sustainable and effective public policies.
