The Process of Health Legislation Reform in the Republic of Slovenia

2000 ◽  
Vol 7 (1) ◽  
pp. 73-84
Author(s):  
◽  

AbstractSlovenia was among the first European countries to introduce laws and regulations in the social security field, including public health. The current health legislation is the culmination of a century-long development of the health care system through different periods and diverse political and economic conditions affecting the region. The present organization of the health care system reflects the pattern of partnership which already existed in the former Yugoslavia. The ultimate goal of all countries is to implement health care activities within a system ensuring active participation and partnership of citizens who are universally covered by a public health insurance scheme, health legislators and providers of health services. Slovenia has therefore not been confronted with any major difficulties in implementing health care system reforms. By amending and modifying its health legislation Slovenia will build upon its good points, improve clarity and integrate certain approaches important for the functioning of its health care system in the European Union when Slovenia becomes a full member. Changes are directed towards:strengthening inter-sectoral cooperation and health and safety at work;creating environments supporting a healthy life style and emphasizing personal responsibility for one's own health;— maintaining a unified public health insurance scheme and sufficient financing through employer and employee contributions;— introducing voluntary health insurance;— developing in a controlled way an efficient and effective private medical practice;— strengthening of management in public health institutions and increasing staff's responsibility for business success.— implementing quality improvement systems.

2015 ◽  
Vol 25 (6) ◽  
pp. 695-704 ◽  
Author(s):  
Sarah-Jo Sinnott ◽  
Charles Normand ◽  
Stephen Byrne ◽  
Noel Woods ◽  
Helen Whelton

2014 ◽  
Vol 61 (1) ◽  
pp. 36-44 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Jovana Aleksic ◽  
Neda Stojanovic ◽  
Slavoljub Zivkovic

Introduction. The backbone of Serbian health system forms the public healthcare provider network with 355 institutions and around 112,000 employees, owned and controlled by the Ministry of Health and financed mainly by the Republican Health Insurance Fund. The law recognizes private practice that was not included, till recently, in the public funding scheme. New Health Insurance Law (2005) decreased the number of entitlements in the basic health service package. It abolished the right to dental health care for adults (exceptions are: children, older than 65, pregnant women and emergency cases) as well as the right to compensate travel expenses. The aim of this study was to evaluate the effects of health care system of the Republic of Serbia and indicate parameters that determine the state of health of the population, on the ground of data obtained by the Institute of Public Health of Serbia. Results. In the period 2004-2012, cardiovascular diseases represented the main cause of illness in Serbia (50%). In 2012 digestive system diseases were on the second place. Neoplasm and nervous system diseases were on the third place. From 2007 to 2012 there was slight decline in the birth rate and number of deaths, but the death rate increased from 13.9 to 14.2. Health care system in Serbia is funded through the combination of public finances and private contributions. Primary care is provided in 158 health care centres and health care stations, secondary and tertiary care services are offered in general hospitals, specialized hospitals, clinics, clinico-hospital centers and clinical centres. Conclusion. A significant but not satisfactory progress has been achieved in the field of health status indicators as the most important outcome of the final performance of the health system. The transition of public health care system in Serbia since the communist period to present and slow integration with European Union is unfinished process.


2020 ◽  
Author(s):  
Tesfaye Gebremedhin ◽  
Itismita Mohanty ◽  
Theo Niyonsenga

Abstract Background: Janani Suraksha Yojana (JSY), a conditional cash transfer program in India, incentivized women to deliver at institutions and resulted in a significant increase in institutional births. Another major health policy reform, which could have influenced maternal and child health care (MCH) utilisation, was the public health insurance scheme called Rashtriya Swasthya Bima Yojana (RSBY) launched in 2008. However, there is lack of evidence on how RSBY impacted MCH utilisation in India. This study investigated the impact of health insurance (in particular, the public insurance scheme versus private insurance) on a continuum of MCH utilisation. We also investigated whether maternal empowerment was a significant correlate that affects MCH utilisation. Methods: The study used a multilevel mixed effect ordered logistic regression modelling, using a cohort of mothers whose delivery was captured in both the 2005 and 2011/12 rounds of the Indian Human Development Survey (IHDS). We derived indexes for women’s empowerment using Principal component analysis (PCA) technique applied to various indicators of women’s autonomy and socio-economic status. Results: Our results indicated, mothers’ MCH utilization levels vary by district, community and mother over time. The effect of the public insurance scheme (RSBY) on MCH utilisation was not as strong as privately available insurance. However, health insurance was only significant in models that did not control for household and mother level predictors. Our findings indicated that maternal empowerment indicators – in particular, maternal ability to go out of the house and complete chores and economic empowerment - were associated with higher utilization of MCH services. Among control variables, maternal age, education and household wealth were significant correlates that increase MCH service utilization over time. Conclusions: Change in women’s and societal attitude towards maternal care may have played a significant role in increasing MCH utilisation over the study period. There might be a need to increase the coverage of the public insurance scheme given the finding that it was less effective in increasing MCH utilisation. Importantly, policies that aim to improve health services for women need to take maternal autonomy and empowerment into consideration.


2013 ◽  
Vol 48 ◽  
pp. 55-77 ◽  
Author(s):  
Volkan Yilmaz

AbstractHealth care reforms have always been critical political arenas within which the parameters of citizens' access to health care services and thus the new terms of social bargain that backs social policies are negotiated. Despite the relative success of Turkey in establishing public health insurance schemes and developing a public capacity for health care service delivery since the late 1940s, Turkey's health care system has largely failed to institute equality of access to health care services. With the promise of abolishing the inequalities, the ruling Justice and Development Party (AKP) launched Turkey's Health Transformation Program in 2003. Since then, Turkey's health care system has been undergoing a significant transformation. On the one hand, with the unification of all public health insurance schemes under a compulsory universal health insurance scheme and the equalization of benefit packages for all publicly insured, the program has succeeded in abolishing the occupational status-based inequalities in access to health care services. On the other, this article suggests that the program has changed the main origin of inequalities in service access from occupational status to income. As the country suffers from an uneven distribution of income, it is argued that these incomebased inequalities in access pose a significant threat to the realization of the social citizenship ideal in Turkey.


2021 ◽  
pp. 1-18
Author(s):  
Linn Kullberg ◽  
Paula Blomqvist ◽  
Ulrika Winblad

Abstract Voluntary private health insurance (VHI) has generally been of limited importance in national health service-type health care systems, especially in the Nordic countries. During the last decades however, an increase in VHI uptake has taken place in the region. Critics of this development argue that voluntary health insurance can undermine support for public health care, while proponents contend that increased private funding for health services could relieve strained public health care systems. Using data from Sweden, this study investigates empirically how voluntary health insurance affects the public health care system. The results of the study indicate that the public Swedish health care system is fairly resilient to the impact of voluntary health insurance with regards to support for the tax-based funding. No difference between insurance holders and non-holders was found in willingness to finance public health care through taxes. A slight unburdening effect on public health care use was observed as VHI holders appeared to use public health care to a lesser extent than those without an insurance. However, a majority of the insurance holders continued to use the public health care system, indicating only a modest substitution effect.


Author(s):  
Obelebra Adebiyi ◽  
Foluke Olukemi Adeniji

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires. Data were collated and analyzed using SPSS version 21.0. A Chi-square test was carried out. The level of Confidence was set at 95%, and the P-value ≤ .05. Out of a total of 334 respondents, 280 (83.8%) were enrolled for NHIS, 203 (72.5%) utilized the services of the scheme. Most 181 (82.1%) of the respondents who utilized visited the facility at least once in the preceding year. Although, 123 (43.9%) of the respondents made payments at a point of access to health care services, overall there was a reduction in out of pocket payment. Possession of NHIS card, the attitude of health workers, and patients’ satisfaction were found to significantly affect utilization P ≤ .05. Regression analysis shows age and income to be a predictor of utilization of the NHIS. Though utilization is high, effort should be made to remove payment at the point of access and improving the harsh attitude of some of the health workers.


2009 ◽  
Vol 4 (4) ◽  
pp. 405-424 ◽  
Author(s):  
J. HOLLAND ◽  
N.J.A. VAN EXEL ◽  
F.T. SCHUT ◽  
W.B.F. BROUWER

AbstractTo contain expenditures in an increasingly demand driven health care system, in 2005 a no-claim rebate was introduced in the Dutch health insurance system. Since demand-side cost sharing is a very controversial issue, the no-claim rebate was launched as a consumer friendly bonus system to reward prudent utilization of health services. Internationally, the introduction of a mandatory no-claim rebate in a social health insurance scheme is unprecedented. Consumers were entitled to an annual rebate of ₠ 255 if no claims were made. During the year, all health care expenses except for GP visits and maternity care were deducted from the rebate until the rebate became zero. In this article, we discuss the rationale of the no-claim rebate and the available evidence of its effect. Using a questionnaire in a convenience sample, we examined people’s knowledge, attitudes, and sensitivity to the incentive scheme. We find that only 4% of respondents stated that they would reduce consumption because of the no-claim rebate. Respondents also indicated that they were willing to accept a high loss of rebate in order to use a medical treatment. However, during the last month of the year many respondents seemed willing to postpone consumption until the next year in order to keep the rebate of the current year intact. A small majority of respondents considered the no-claim rebate to be unfair. Finally, we briefly discuss why in 2008 the no-claim rebate was replaced by a mandatory deductible.


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