Establishing NHA provided a pattern of national healthcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. Analysing a period 2003-2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.
Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but its structure and scope of services is still undervalued as compared to public sector
Introduction. Health care, as one of the most important and sensitive fields of human endeavour, has a significant social impact; therefore changes in this area have wide implications on society in general. The latest economic crisis resulted in slow growth of gross domestic product (GDP), high unemployment rates, low living standards, and increased poverty across the globe. This includes decreased capacity of health system, and reduced quality and supply of health services. The aim of the study was to explore possible impact of the current world economic crisis on the public health sector workforce in Serbia. Materials and Methods. The study was conducted as retrospective analyses of the Public Health Institute (PHI) human resource data, the Republic Statistical Office publications and database, the Republic Development Bureau report, as well as the analysis of healthcare expenditures obtained from the Chamber of Health Institutions reports. The comparative analytical method was used for the assessment of socio-economic and human resource indicators over the period of five years, 2006 to 2010. Results. Results showed that the world economic crisis discontinued steady economic growth in Serbia. Between 2006 and 2008, the real GDP growth rate has been fluctuating between 3.6% and 5.4 %, while in 2009 it had negative growth rate of -3.1 % and slight increase in 2010 of 1.0%. In 2006, the GDP per capita was US$ 3,943, and by 2008 it almost doubled reaching US$ 6,498, while in 2009 it fell down to US$ 5,499, and continued decrease in 2010 to US$ 5,006. In 2007, the overall inflation rate was 6.5%, and after fluctuaion between 11.7% in 2008 and 8.4% in 2009 it droped again to 6.5% in 2010. According to the PHI, from 2006 to 2008 there was steady increase of full-time employees in the public health care sector; from 108,975 in 2006 to 114,317 in 2008. In 2009, the number of full-time employees slightly declined to 114,175 and 114,432 in 2010. There was constant increase in total number of employees in the public health care sector, from 125,081 in 2006 to 129,357 in 2008. In 2009, the total number of employees decreased to 128,694 and in 2010 to 122,695. At the same time, the total expenditure of human resources in the health sector as the percentage of total health expenditure declined from 37.7% in 2006 to 34.7% in 2010. The public health sector salaries after steady increase from 59.9% of total health expenditure in 2006 to 61.2% in 2007 and 2008, decreased to 56.2% in 2010. The unemployment rate for medical doctors almost doubled in 2010 as compared to 2006. Conclusion. Preliminary study results showed that the world economic crisis had negative impact not only on GDP growth rate, the inflation and unemployment rate, but on the public health sector workforce, their salaries and unemployment rate in Serbia
Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (€ 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (€ 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004
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