The Effect of Decentralised Public Health Care Provision on Accessibility To Medicines in Bosnia And Herzegovina

Abstract

Objectives: The economical crisis and the requirements for structural changes in all aspects of public health brought a new era of reforms in the country as well as the health care system itself. The Pharmaceutical Legislation, both European and national, were implemented to protect public and state interests. Application of new legislation influenced provider of health care services in different areas. Therefore it is important to evaluate the impact and performance on costs and revenues of health care services provider. MethOds: Monitoring, calculation and assessment of costs and revenues with the help of financial analysis indicators for years 2003-2012, using financial statements was conducted, with respect to profitability, debt, liquidity, working capital and efficiency ratios. These ratios constituted significant information of implementing new health care legislation and price policies. Results: In case of profitability, parameter gross profit ranged from x 2003-2011 = 16.1-22.8% (x average = 19.2%, X mean = 19.8%, σ = 2.4), but in 2012 decreased on 14.3%. Net profit ranged x 2003-2011= 12.8-18.3% (x average = 14.6%, X mean = 16.6%, σ = 4.9%), while in 2012 reached only 2.3%. Debt parameters varied from x 2003-2012= 2.33-4.8 (x average = 3.44, X mean = 3.06, σ = 0.82), liquidity parameters current ratio x 2003-2012 = 1.1-1.7 (X average = 1.43, X mean = 1.45, σ = 0.15) and quick ratio x 2003-2012= 0.7-1.3 (x average = 1.16, x mean = 1.09, σ = 0.15), working capital ratio x 2003-2012 = 2,7-12,9, (X average = 9.6, X mean = 10.1, σ = 3.1) and efficiency ratios were measured either. cOnclusiOns: Implementation of new health care legislation and price policy that were intended to apply restrictive measures to increase system efficiency and cost savings had a significant impact on health care services providers by worsening profitability and liquidity parameters as key indicators of provider stability. Despite the improvement in debt ratio, working capital ratio and efficiency ratios, stability may be threatened and may affect the amount of health care services providers. PHP265 THe effecT of DecenTraliseD Public HealTH care Provision on accessibiliTy To MeDicines in bosnia anD HerzegovinaMelck B. , Ando G. , Izmirlieva M. IHS, London, UKObjectives: This study aims to assess the extent of the restriction on access to medicines in Bosnia and Herzegovina in relation to the country's decentralised provision of health care, with three separate state entities and 10 cantons within the federation of Bosnia and Herzegovina all having a role in the provision of public health care. MethOds: A comparison was made between the contents of the federal essential drug list and the drug lists of the various entities and cantons, in order to ascertain which medicines were available, at what price, and with what level of reimbursement. Results: The federal essential list contains the basic INNs which must be provided by each canton, but there were some important differences between the lists of the various entities and cantons. F...