The Public Hospital System in Macedonia

Lazarevik, Vladimir; Donev, Doncho

doi:10.1057/9781137264770_8

Cited by 3 publications

(4 citation statements)

References 10 publications

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“…Arising of parallel doctors' unions is also perceived among the majority of the doctors as direct influence of politics in the health care system. The influence of politics in the health care system in Macedonia was also documented elsewhere [15,24].…”

Section: Discussionmentioning

confidence: 79%

Medical Doctors’ Attitudes towards Pay-For-Reporting in Macedonia: A Web-Based Cross-Sectional Survey. Maced J Med Sci. 2012 Dec 15; 5(4):437-443

Lazarevik

Kasapinov

2012

Maced J Med Sci

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Objective: To determine medical doctors' attitudes towards the implementation of the new pay-forreporting system in the public hospital sector.Data Source: An electronic survey was conducted among 303 medical doctors in the Republic of Macedonia using the database of Healthgrouper.com, an online provider of information for healthcare providers.Principal Findings: Majority (61.9%) of all surveyed doctors are against the proposed pay-for-reporting (P4R) reform. Disapproval is much higher among the doctors employed at the public hospitals where 79% consider that pay-for-reporting project has to be abandoned. Doctors are against the proposed P4R system that only measures quantity of the work. According to majority of the doctors current model is subjective; it opens possibilities for bias and missconduct, and puts the clinical teamwork at jeopardy. Conclusions:Massive support against the implemented P4R reform was expressed by the Macedonian doctors employed in the public sector. The model should integrate parameters such as quality and complexity of delivered services to patients. Better integration and engagement of doctors is essential to assure support and smooth implementation of P4R reform as sound policy in practice. The Ministry of Health should set key parameters to be monitored by hospitals to evaluate the success of the P4R system.

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Section: Discussionmentioning

confidence: 79%

Medical Doctors’ Attitudes towards Pay-For-Reporting in Macedonia: A Web-Based Cross-Sectional Survey. Maced J Med Sci. 2012 Dec 15; 5(4):437-443

Lazarevik

Kasapinov

2012

Maced J Med Sci

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“…The rationalization of hospitals by way of mergers represents a common practice in developed countries (Healy and McKee, 2002b). In addition, Lazarevik and Donev (2012) see this as an option that could contribute to the improvement of hospital efficiency in Macedonia. However, all issues deriving from this should be taken into consideration, for example, e178 the influence of mergers on accessibility of hospital care from the aspect of the vicinity of the hospital to the place of living (Buchmueller, Jacobson, Wold, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…As one of the characteristics of the inherited socialist healthcare systems, the international discussion (focusing mainly on the Soviet model) points out the problem of an over‐scaled, fragmented and inefficient hospital sector (Healy and McKee, ; Ho and Ali‐Zade, ; Healy and McKee, ). Concentrating on the Yugoslav heritage, Lazarevik and Donev () state that Macedonia inherited a healthcare infrastructure that is widely distributed, easily accessible and massive and comprises big hospitals. Having these problems in mind, the need for capacity downsizing imposed itself as an important topic in the international discussion focusing on the post‐socialist countries as well as in the wider international discussion (McKee and Healy, ).…”

Section: Methods and Datamentioning

confidence: 99%

“…The prevailing opinion is that the outcomes of the reforms in post‐socialist countries did not meet the expectations (Björkman and Nemec, ) and were not the result of a planned development but of ad hoc reactions to the bad economic situation and additional aggravating political circumstances and as such did not contribute to a significant improvement in the hospital sector (Healy and McKee, ; Ho and Ali‐Zade, ; Healy and McKee, ). Different authors studied how post‐socialist countries tried to resolve the problems in the hospital sector: Lazarevik and Donev () for Macedonia, Delcheva and Balabanova () for Bulgaria, Nuri () for Albania, Jakubowski and Jeganjec () for Bosnia and Herzegovina, while Dovijanić () gives a review of the healthcare service and the organization of healthcare institutions in Serbia.…”

Section: Methods and Datamentioning

confidence: 99%

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Reconfiguration of acute care hospitals in post-socialist Serbia: spatial distribution of hospital beds

Matejic

2016

Int J Health Plann Mgmt

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In the context of healthcare reforms in post-socialist Serbia, this research analyses the reconfiguration of acute care hospitals from the aspect of the spatial distribution of hospital beds among and within state-owned hospitals. The research builds a relationship between the macro or national level and the micro or hospital level of the spatial distribution of hospital beds. The aim of the study is to point out that a high level of efficiency in hospital functionality is difficult to achieve within the current hospital network and architectural-urban patterns of hospitals, and to draw attention to the necessity of a strategically planned hospital spatial reconfiguration, conducted simultaneously with other segments of the healthcare system reform. The research analyses published and unpublished data presented in tables and diagrams. The theoretical platform of the research covers earlier discussions of the Yugoslav healthcare system, its post-socialist reforms and the experiences of developed countries. The results show that the hospital bed distribution has not undergone significant changes, while the hospital spatial reconfiguration has either not been carried out at all or, if it has, only on a small scale. All this has contributed to overall inadequate, inflexible, inefficient, defragmented and unequal bed distribution. Copyright © 2016 John Wiley & Sons, Ltd.

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North Macedonia

Kacarska¹,

Kostova²

2021

Health Politics in Europe

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This chapter offers an in-depth look at health politics and the compulsory health insurance system in North Macedonia. It traces the development of the North Macedonian healthcare system, characterized by the establishment of decentralized free-for-all-at-point-of-delivery health system during communism, which served as a basis for the current system. Since the early 1990s, when North Macedonia declared independence and started a transition towards democracy and a free market economy, North Macedonian health politics focused on permitting private provision, establishing a compulsory health insurance system, and integrating private services in the public insurance. Despite support from international organizations, the reform process was hampered by economic difficulties, inter-ethnic conflict, and the conflict with Greece regarding North Macedonia. As highlighted in the chapter, the main healthcare challenges have been to ensure the insurance system’s fiscal solvency, the conversion of primary care provision from local public health centers into private practices, and, since 2012, the integration of higher level private hospital services into the public system in order to reduce out-of-pocket payments and ensure equal geographical access.

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The Public Hospital System in Macedonia

Cited by 3 publications

References 10 publications

Medical Doctors’ Attitudes towards Pay-For-Reporting in Macedonia: A Web-Based Cross-Sectional Survey. Maced J Med Sci. 2012 Dec 15; 5(4):437-443

Medical Doctors’ Attitudes towards Pay-For-Reporting in Macedonia: A Web-Based Cross-Sectional Survey. Maced J Med Sci. 2012 Dec 15; 5(4):437-443

Reconfiguration of acute care hospitals in post-socialist Serbia: spatial distribution of hospital beds

North Macedonia

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