 | This article needs to be updated.(March 2018) |
Healthcare in Serbia is delivered by means of a universal health care system.
| This article needs to be updated.(March 2018) |
Healthcare in Serbia is delivered by means of a universal health care system.
The general reorientation of health services towards social and preventive medicine and primary health care was officially accepted in the Federal Republic of Yugoslavia after the Second World War. It built on some fundamental principles introduced in the 1930s by Dr Andrija Štampar. Primary health care (at that time called basic care) in the Yugoslav health system held a priority position for more than 40 years. However, from the beginning of the 1960s, preserving primary health care as the "center of the system" faced serious challenges, including a centralized and vertically programmed approach to preventive medicine, inadequate skills and competencies of health professionals in health promotion, and a relatively low economic and social status of health professionals in primary health care. [1]
Between the 1960s and 1980s, little effort was made to improve the status and performance of primary health care. Meanwhile, an experiment with self-governing communities of interest in the health sector further decreased the efficiency and quality of services. [1]
With the violent disintegration of the former Yugoslavia in 1991, the already weakened and structurally distorted economy of the Republic of Serbia entered an acute phase of the crisis, with drastic consequences to the health care system and to other social sectors. Due to dwindling real resources, as well as to an inefficient, over-extended and poorly managed public health sector, health care has been facing huge problems: frequent shortage of basic drugs and medical supplies, inadequate nutrition of patients, obsolete and broken medical equipment, and lack of basic materials, a deteriorating infrastructure and demoralized staff. Consequently, the quality and quantity of health services sharply deteriorated. [2]
The first strategic paper was enacted two years after the political changes of October 5, 2000 and later in comparison with reforms in other welfare programs. Only in 2005 were the new Laws regulating health care and health insurance adopted. The dominant provider of health care services is still the state, and the organization of public health care facilities has been characterized by an insufficiently clear division of levels of care. Compared to the period of socialism, the most striking changes were made with the introduction of mandatory health insurance and the widening of the scope of work and types of private health care services.
Along with the dominance of the public sector, the activities of the private health care sector have been steadily increasing. They are mainly offered at the level of primary health care, but also at the level of highly profitable specialized health care services. However, any of the so far implemented reforms did not prevent the parallel existence of the two sectors. The functioning of the private sector is still lacking completely clear regulations. [3]
Private health insurance has a short history; it is regulated by the Regulation on Voluntary Health Insurance in Serbia of 2008. Private health insurance is designed as a form of substitution for those without a public insurance and for those opting for higher standards.
In 2014, the Chairperson of "Doctors Against Corruption" was appointed a Special Adviser to the Ministry of Health. [4]
In October 2015, the List of Licensed Medical Practitioners appeared on the Serbian Medical Chamber's website, which wasn't previously accessible to the citizens. [5]
The Health Protection Act and the Health Insurance Act came into force on 11 April 2019. There is a list of health institutions that cannot be privately owned:
A Register of Health Institutions is to be established by the Agency for Business Registers of Serbia by October 11, 2020. A common waiting list system is to be established.
Patients are obliged to submit to targeted preventive examinations. If they fail to undergo a mandatory screening without justification, they have to contribute a maximum of 35% of the total cost of health services if they are diagnosed before the next screening cycle begins.
Gifts worth more than 5% of the average monthly net salary in Serbia to health professionals are outlawed. [6]
The healthcare system is managed by the National Health Insurance Fund (NHIF), which covers all citizens and permanent residents. All employees, self-employed persons, and pensioners must pay contributions to it. Contributions are based on a sliding scale, with wealthier members of society paying higher percentages of their income. [7] Despite this, corruption still remains a serious problem due to low salaries, with many doctors demanding bribes in exchange for better treatment, although there is a major campaign against corruption from the government and NGOs. [8]
As of 2014, the expenditure on health care in Serbia was 10.37% of GDP in 2014, US$1,312 per capita. [9] Also, as of 2014, Serbia had 308 doctors per 100,000 people (360 per 100,000 people was the European Union (EU) average) and 628 non-doctoral medical staff per 100,000 people (1,199 per 100,000 people was the EU average). [9] Although there is a trend toward a decreasing number of hospital beds per 100,000 people in Europe due to better efficiency and diagnostics, Serbia is among the countries in Europe with 552 hospital beds per 100,000 people. [9] [10] In terms of the availability of medical equipment, Serbia is slightly trailing behind the average of EU countries. [9]
The Government of Serbia is working with the World Bank to improve the quality and efficiency of Serbia's healthcare system. [11]
Self care is mainly practiced when a patient is already ill versus as a preventive measure. Care is usually sought from healthcare professionals such as doctors or nurses where bribes are commonly expected, but some folk medications are used such as teas, vinegar, herbs, and vitamins. Changes in activity levels such as more rest or increased exercise are sometimes used as curative measures for illness, and perceived causes of illness may be improper diet or fate. [12] Most former Yugoslavians feel health is not the absence of disease, but rather it is “wealth and the most important thing in life" and "to have enough strength”. [13]
Health care reform is for the most part governmental policy that affects health care delivery in a given place. Health care reform typically attempts to:
Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.
The healthcare industry is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. It encompasses the creation and commercialization of products and services conducive to the preservation and restoration of well-being. The contemporary healthcare sector comprises three fundamental facets, namely services, products, and finance. It can be further subdivided into numerous sectors and categories and relies on interdisciplinary teams of highly skilled professionals and paraprofessionals to address the healthcare requirements of both individuals and communities.
Primary care is a model of care that supports first-contact, accessible, continuous, comprehensive and coordinated person-focused care. It aims to optimise population health and reduce disparities across the population by ensuring that subgroups have equal access to services.
Health care in Saudi Arabia is a national health care system in which the government provides free universal healthcare coverage through a number of government agencies. There is also a growing role and increased participation from the private sector in the provision of health care services.
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society". According to the World Health Organization, an explicit health policy can achieve several things: it defines a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people.
The healthcare reform in China refers to the previous and ongoing healthcare system transition in modern China. China's government, specifically the National Health and Family Planning Commission, plays a leading role in these reforms. Reforms focus on establishing public medical insurance systems and enhancing public healthcare providers, the main component in China's healthcare system. In urban and rural areas, three government medical insurance systems—Urban Residents Basic Medical Insurance, Urban Employee Basic Medical Insurance, and the New Rural Co-operative Medical Scheme—cover almost everyone. Various public healthcare facilities, including county or city hospitals, community health centers, and township health centers, were founded to serve diverse needs. Current and future reforms are outlined in Healthy China 2030.
Healthcare in Turkey consists of a mix of public and private health services. Turkey introduced universal health care in 2003. Known as Universal Health Insurance Genel Sağlık Sigortası, it is funded by a tax surcharge on employers, currently at 5%. Public-sector funding covers approximately 75.2% of health expenditures.
As literacy and socioeconomic status improves in Ethiopia, the demand for quality service is also increasing. Besides, changes in the demographic trends, epidemiology and mushrooming urbanization require more comprehensive services covering a wide range and quality of curative, promotive and preventive services.
Healthcare in Finland consists of a highly decentralized three-level publicly funded healthcare system and a much smaller private sector. Although the Ministry of Social Affairs and Health has the highest decision-making authority, specific healthcare precincts are responsible for providing healthcare to their residents as of 2023.
Hong Kong's medical infrastructure consists of a mixed medical economy, with 12 private hospitals and 43 public hospitals. Hong Kong has high standards of medical practice. It has contributed to the development of liver transplantation, being the first in the world to carry out an adult to adult live donor liver transplant in 1993. Both public and private hospitals in Hong Kong have partnered with the Australian Council on Healthcare Standards (ACHS) for international healthcare accreditation. There are also polyclinics that offer primary care services, including dentistry.
Healthcare in Georgia is provided by a universal health care system under which the state funds medical treatment in a mainly privatized system of medical facilities. In 2013, the enactment of a universal health care program triggered universal coverage of government-sponsored medical care of the population and improving access to health care services. Responsibility for purchasing publicly financed health services lies with the Social Service Agency (SSA).
Costa Rica provides universal health care to its citizens and permanent residents. Both the private and public health care systems in Costa Rica are continually being upgraded. Statistics from the World Health Organization (WHO) frequently place Costa Rica in the top country rankings in the world for long life expectancy. WHO's 2000 survey ranked Costa Rica as having the 36th best health care system, placing it one spot above the United States at the time. In addition, the UN has ranked Costa Rica's public health system within the top 20 worldwide and the number 1 in Latin America.
Examples of health care systems of the world, sorted by continent, are as follows.
According to the Constitution of Albania, citizens are entitled to healthcare. The healthcare system in Albania is primarily public. The public system is made up of three tiers: primary care, secondary care, and tertiary care. Primary healthcare covers basic health needs. Secondary healthcare is needed when seeing a specialist after being referred to by a general practitioner. Tertiary healthcare funds are dedicated for highly specialized medical care that is needed over a long duration of time. There are over 400 public clinics that offer both primary and secondary healthcare services, along with over 40 public hospitals that offer tertiary healthcare services.
A new measure of expected human capital calculated for 195 countries from 1990 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by The Lancet in September 2018. Latvia had the twenty-first highest level of expected human capital with 23 health, education, and learning-adjusted expected years lived between age 20 and 64 years.
As of 2019 Lithuanian life expectancy at birth was 76.0 and the infant mortality rate was 2.99 per 1,000 births. This is below the EU and OECD average.
In the past, Kosovo’s capabilities to develop a modern health care system were limited. Low GDP during 1990 worsened the situation even more. However, the establishment of the Faculty of Medicine in the University of Pristina marked a significant development in health care. This was also followed by launching different health clinics which enabled better conditions for professional development.
The Health in North Macedonia is improving. The Macedonian life expectancy in 2016 was 74 for men and 78 for women. In 2015 it was estimated that 11.44% of the Macedonian population had diabetes, costing about $403 per person per year. In 2015 it had the fourth highest rate of death from non-communicable diseases in Europe.
