
Sağlık Bakanlığı Ek Ödeme Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik bugünkü Resmi Gazete'de yayımlandı.
Yönetmelikte, temel ek ödeme (sabit ve taban ödemelerin toplamıyla belirlenen oran) ve teşvik ek ödemesinden oluşan "ek ödemeler" konusunda yeni düzenlemeler yapıldı, birinci basamak sağlık kuruluşlarında ve Bakanlık laboratuvarlarında çalışan personel de teşvik ek ödemesi kapsamına alındı.
Buna göre, birinci basamak sağlık kuruluşları ve Bakanlık laboratuvarlarında çalışanların teşvik ek ödemesinde, işin ve sağlık hizmetinin özelliğine göre, bulaşıcı hastalık sürveyansı, kanser tarama hizmetleri, çevre sağlığı ve tütün kontrolü hizmetleri, tüberküloz takibi ve doğrudan gözetimli tedavi, iş sağlığı ve güvenliği hizmetleri, özel sağlık kuruluşları ile eczane ve ecza deposu denetimleri, koruyucu sağlık hizmetleri eğitimi; 112 acil sağlık hizmetleri kapsamında çağrı cevaplama oranı, vakaya erişim ve hastaneye teslim süresi ile günlük vaka sayısı, laboratuvarlarda numune sayısı ve numune çeşitliliği, analiz, numune ve analiz sonuçlandırma süresi ile personelin görev yeri, görevi, kadro ve unvanı gibi kriterlere bakılacak.
Bu kriterler doğrultusunda Bakanlıkça belirlenen birim teşvik hedeflerinin gerçekleşme durumuna göre 0 ile 1 arasında değişen birim teşvik katsayısı esas alınacak. Toplu sözleşme hükümlerinden kaynaklanan artışlar da birim teşvik katsayısına eklenecek.
Teşvik ek ödemesi, personelin kadro unvanına göre, hak ettiği taban ödemenin birim teşvik katsayısı ve aktif çalışma gün katsayısı ile çarpımı sonucu bulunacak. Bu tutar, profesör ve doçent unvanlı personel ile entegre ilçe devlet hastanesi başhekimi, toplum sağlığı merkezi başkanı, halk sağlığı laboratuvarı sorumlusu ve yan dal uzmanları için yüzde 20'ye kadar artırımlı uygulanabilecek.
Yapılan değişiklikle Ek Ödeme Yönetmeliğinin kapsamına, Sağlık Hizmetleri Temel Kanunu'nun ek 9'uncu maddesi hükümleri çerçevesinde birlikte kullanım kapsamında hizmet sözleşmesi imzalanan üniversite personeli de alındı.
Katsayılarla ilgili tablolarda değişiklik
Düzenlemeyle eczacıların taban ödeme katsayısı 0,50'den 1,20'ye çıkarıldı.
Yönetmeliğin "Ek-2 sayılı Hizmet Alanı-Kadro Unvan Katsayıları" (HAKUK) tablosuna yeni alanlar eklendi. Tabloda, "Tıbbi Histoloji ve Embriyoloji (Üremeye Yardımcı Tedavi ÜYTE) merkezleri ile ilgili mevzuatı kapsamında ruhsat/faaliyet izin belgesi bulunan laboratuvarlarda görev yapanlar" yer aldı, mesai içi tavan ek ödeme tutarına esas katsayıları ise 2,3 olarak belirlendi.
Profesörlerin (eğitim görevlisi, uzman tabip / başasistan kadrosuna atananlar dahil) katsayısı ilgili branş HAKUK'unun yüzde 140'ı, doçentler (eğitim görevlisi, doktor öğretim üyesi / uzman tabip / başasistan kadrosuna atananlar dahil) için ilgili branş HAKUK'unun yüzde 130'u, diğer eğitim görevlileri için yüzde 120'si olacak şekilde artırıldı.
Ayrıca tıbbi işlemler puanı bulunmayan tıbbi ve idari ünitelerde, sağlık tesislerine entegre 112 acil sağlık istasyonlarında çalışan tabip, diş tabibi, uzman tabip ve uzman diş tabibi ile branşı için HAKUK belirlenmemiş uzman tabipler ve tıpta uzmanlık mevzuatına göre uzman olanların katsayısı 1,2 şeklinde belirlendi.
Katsayılar, yoğun bakım, palyatif bakım merkezleri, yeni doğan, yanık, evde sağlık hizmetleri, diyaliz ve kemik iliği nakil ünitelerinde çalışan pratisyen tabipler ile branşı için HAKUK belirlenmemiş uzman tabipler için 1,7, ilk ve acil yardım kliniklerinde, acil servis / polikliniklerinde görev yapan pratisyen tabipler ile branşı için HAKUK belirlenmemiş uzman tabipler için de katsayı 1,8 oldu.
Klinik idari ve eğitim sorumlularının HAKUK'ları yüzde 10 artırımlı uygulanacakken, bu artırım, idari ve eğitim sorumlusunun aynı kişi olması durumunda bir defa yapılacak. Ayrıca branşı için HAKUK belirlenmemiş uzman tabiplerin, sağlık tesisinde uzmanlık branşı ile ilgili tıbbi hizmet sunum alanlarında fiilen görev yapmaları halinde ilgili branşın HAKUK'u 3 olacak.
Yönetmelikte, artırımlı ödeme yapılacak hizmet sunum alanı tablosunda da "evde sağlık hizmetleri, girişimsel radyoloji birimleri" ile "nükleer tıp hizmetleri" yer alırken, yataklı servislerin sorumlularına ek katsayı eklenmesi de düzenlendi.
"Sağlık Tesisi Puan Ortalamasından Yararlanacaklar Tablosu"nda değişikliklerin yapıldığı yönetmelikte, ek puan tablosunda da başhekim tarafından fiilen mutemetlik hesaplamaları yapmak üzere görevlendirilen, tescilli yatak sayısı 249 ve altında olan sağlık tesisleri ile ağız ve diş sağlığı merkezlerindeki (ADSM) personelin oranları yer aldı.
Ayrıca ilgili ek ödeme dönemi net teşvik puan hesaplamasında bilimsel çalışma puanları toplamının 5 bini geçemeyeceği düzenlendi. Bu oran daha önce 2 bin olarak uygulanıyordu.
Yönetmelik, 1 Ekim 2022 tarihinden geçerli olmak üzere yürürlüğe girdi.
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