scholarly journals Assessment of financial flow in the health system of Serbia in a period 2003-2006

2010 ◽  
Vol 67 (5) ◽  
pp. 397-402 ◽  
Author(s):  
Milena Gajic-Stevanovic ◽  
Nevenka Teodorovic ◽  
Snezana Dimitrijevic ◽  
Dragan Jovanovic
Keyword(s):  
Health Services ◽  
Health System ◽  
National Health ◽  
Health Expenditures ◽  
Financial Resources ◽  
Healthcare Expenditures ◽  
State Institutions ◽  
European Unity ◽  
Financial Flow ◽  
Health Accounts

Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Conclusion. Establishing NHA provided a pattern of national healtcare 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.

scholarly journals Community Empowerment in Health: An Exploratory Study in Rural Community of a District of West Bengal

2020 ◽  
pp. 11-19
Author(s):  
Dipta Kanti Mukhopadhyay ◽  
Sujishnu Mukhopadhyay ◽  
Nivedita Das ◽  
Tarun Kumar Sarkar ◽  
Fasihul Akbar ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
National Health ◽  
Rural Areas ◽  
West Bengal ◽  
Health Workers ◽  
Community Empowerment ◽  
Current Status ◽  
Health Staff ◽  
Key Informants

Background: Community empowerment is the process and outcome where community itself is able to identify, prioritize health problems and address them. It has been considered as the key strategy for scalability and sustainability of health services. Objectives: To explore the status of community empowerment in health in rural areas in West Bengal, India and the interplay of different stakeholders. Methods: A cross-sectional, qualitative study was conducted in 2017 – 2018 among the people residing in rural areas of Birbhum district in West Bengal, India who utilized the public health system (lay informants), formal and informal leaders of the community, community level health workers and peripheral health staff (key informants). Three community blocks, two sub-centers from each block and one village from each sub-center were selected randomly. In-depth interviews were conducted among 36 lay and 36 key informants using Laverack’s nine dimension model of community empowerment. Framework analysis was done to summarize data. Results: Participation of people was restricted to awareness and utilization of existing health services. Unmet aspiration for greater participation was noted among a small section of the community. They were mostly fitted to the role of beneficiaries. Functioning of village level organization to promote communitization as envisaged in national health programmes was largely deficient. The community health workers acted as the most peripheral appendages of formal health system rather than the health activists to empower community regarding community’s health. Conclusion: Although, every national health programme advocated community empowerment, the current status and the process of empowerment in health is in nascent stage.

scholarly journals Health expenditures by services and providers for 195 countries, 2000–2017

2021 ◽  
Vol 6 (7) ◽  
pp. e005799
Author(s):  
Matthew T Schneider ◽  
Angela Y Chang ◽  
Abigail Chapin ◽  
Catherine S Chen ◽  
Sawyer W Crosby ◽  
...  
Keyword(s):  
Global Health ◽  
National Health ◽  
Health Expenditure ◽  
National Level ◽  
Health Expenditures ◽  
Multivariate Regression Analysis ◽  
Uncertainty Interval ◽  
Term Care ◽  
Holistic Understanding ◽  
Health Accounts

IntroductionNational Health Accounts are a significant source of health expenditure data, designed to be comprehensive and comparable across countries. However, there is currently no single repository of this data and even when compiled major gaps persist. This research aims to provide policymakers and researchers with a single repository of available national health expenditures by healthcare functions (ie, services) and providers of such services. Leveraging these data within statistical methods, a complete set of detailed health expenditures is estimated.MethodsA methodical compilation and synthesis of all available national health expenditure reports including disaggregation by healthcare functions and providers was conducted. Using these data, a Bayesian multivariate regression analysis was implemented to estimate national-level health expenditures by the cross-classification of functions and providers for 195 countries, from 2000 to 2017.ResultsThis research used 1662 country-years and 110 070 data points of health expenditures from existing National Health Accounts. The most detailed country-year had 52% of the categories of interest reported. Of all health functions, curative care and medical goods were estimated to make up 51.4% (uncertainty interval (UI) 33.2% to 59.4%) and 17.5% (UI 13.0% to 26.9%) of total global health expenditures in 2017, respectively. Three-quarters of the global health expenditures are allocated to three categories of providers: hospital providers (35.4%, UI 30.3% to 38.9%), providers of ambulatory care (25.5%, UI 21.1% to 28.8%) and retailers of medical goods (14.4%, UI 12.4% to 16.3%). As gross domestic product increases, countries spend more on long-term care and less on preventive care.ConclusionDisaggregated estimates of health expenditures are often unavailable and unable to provide policymakers and researchers a holistic understanding of how expenditures are used. This research aggregates reported data and provides a complete time-series of estimates, with uncertainty, of health expenditures by health functions and providers between 2000 and 2017 for 195 countries.

scholarly journals Ordinance 3992/2017: challenges and advances for resource management in the Brazilian Unified Health System (SUS)

2019 ◽  
Vol 53 ◽  
pp. 58
Author(s):  
Blenda Leite Saturnino Pereira ◽  
Antonio Carlos Rosa de Oliveira Junior ◽  
Daniel Resende Faleiros
Keyword(s):  
Resource Management ◽  
Health System ◽  
Financial Resources ◽  
Financial Investment ◽  
Financial Autonomy ◽  
The Past ◽  
Unified Health System ◽  
Financial Flow ◽  
Bank Accounts

To advance in order to overcome the challenge of enabling greater autonomy in the use of financial resources in the Unified Health System (SUS), system managers agreed that transfers from the Union to other federated entities will be carried out through a financial investment account and a costing account. Over the past few years, states and municipalities managed more than 34,000 bank accounts dedicated to the Union’s on-lendings, in which balance exceeded R$8 billion. However, from 2018, Ordinance 3,992/2017 unequivocally separated the budget flow from the financial flow, and the fund-to-fund transfers started to be carried out in only 11,190 bank accounts. Since then, managers have had financial autonomy in the management of financial resources received from the Union, if in accordance w

Greece

2021 ◽  
pp. 353-374
Author(s):  
Ilias Kyriopoulos ◽  
Elias Mossialos
Keyword(s):  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
Health Services ◽  
Health System ◽  
Interest Groups ◽  
Healthcare System ◽  
National Health ◽  
Health Politics ◽  
Care Network

This chapter offers an in-depth look at health politics and the health system in Greece. It traces the development of the Greek healthcare system, characterized by an historical inability to implement significant reform, despite ambitious ideas. The chapter outlines the politics behind several reform attempts, among them the creation in the 1980s of the national health service, key elements of which were never implemented, and more recent efforts to establish a single purchaser of health services and a primary care network, both of which became law but were slow to take off. The chapter argues that the difficulty in undertaking reform can be explained by two elements that have historically influenced the policymaking process in Greece: electoral competition and the power of interest groups.

scholarly journals Regional Health Accounts for Pakistan—Provincial and District Health Expenditures and the Degree of Districts Fiscal Autonomy on Health.

2009 ◽  
Vol 48 (4II) ◽  
pp. 621-634
Author(s):  
Christian Lorenz ◽  
Muhammad Khalid
Keyword(s):  
National Health ◽  
Regional Differences ◽  
Health Expenditure ◽  
Government Expenditure ◽  
Health Expenditures ◽  
Provincial Government ◽  
District Health ◽  
Fiscal Autonomy ◽  
District Government ◽  
Health Accounts

Since May 2009 the first National Health Accounts (NHA) for Pakistan have been finalised and published by Federal Bureau of Statistics (FBS) in cooperation with German Technical Cooperation (GTZ). This paper goes one step ahead the report and analyses in more detail the regional differences in health expenditure structures in Pakistan. The further analyses can be divided into four parts: health expenditures in provinces (Provincial Health Accounts, PHA),2 Punjab provincial and district governments health expenditures and its comparison with ADB figures, all districts of Pakistan and comparison between total district government and provincial government expenditure for each province; the latter calculation is applied as indication for the degree of fiscal autonomy of the districts in each province. Consequently we first analyse the provincial health expenditures by Financial Agents and compare them between the provinces which leads to very heterogeneous results (Section 2); the per capita health expenditures differ from 16 to 23 USD. Secondly, we compare NHA results on Punjab district government with available ADB results and present differences in methods as possible reasons for different results (Section 3). Third, we analyse district data of all district governments in all four Pakistani provinces on the level of detailed function codes in Section 4; the aim is to discover regional differences between districts of the same as well as of different provinces. Fourth, we analyse in Section 5 the degree of fiscal autonomy on health of the districts in each province; therefore we review the ordinance description and compare total district government with total provincial government expenditures per province. Finally we give recommendations for future rounds of NHA in Pakistan regarding formats and necessities of detailed health expenditure data collection to ensure evidence based decision-making not only on federal, but also on provincial and district level. JEL classification: H51, I1, O18, R1 Keywords: National Health Accounts, Health Expenditures, Regional Comparison, Regional Accounts, Fiscal Autonomy, Pakistan

scholarly journals Economic Profile of Iranian Rehabilitation Services: 2002-2017

2021 ◽  
Vol 22 (3) ◽  
pp. 278-297
Author(s):  
Mehdi Basakha ◽  
Keyword(s):  
Health System ◽  
National Health ◽  
Healthcare Services ◽  
Developed Countries ◽  
World Health ◽  
Rehabilitation Services ◽  
System Transformation ◽  
Out Of Pocket Payments ◽  
The World ◽  
Health Accounts

Objective: The role of the service sector in general and healthcare services in particular have been promoting in Iran’s economy. The implementation of the Health System Transformation Plan and the injection of new financial resources into this sector have raised concerns about the health system function. Thus, this is the first attempt to estimate and evaluate the share of rehabilitation services in the Iranian economic and health systems. Materials & Methods: The study utilized longitudinal trend analysis using the National Health Accounts data during 2002-2015. National Health Accounts, through input-output tables, breaks down the share of different sources of financing for different functions of the health system. According to this method, both the share of rehabilitation services in Iran’s economy and the financing sources of these activities have been calculated and compared to other countries. Data on Iran's National Health Accounts has been collected from the Statistical Center of Iran. International data is collected from the World Health Organization's National Health Accounts and the databases of the Organization for Economic Cooperation and Development member countries. Results: Expenditures related to rehabilitation services in Iran increased from 884 billion rials in 2002 to more than 2967 billion rials in 1396, equivalent to 0.02% of Iran's GDP in that year. The share of rehabilitation expenditures in total health expenditures in 2007 was at its highest level (0.3%). In the following years, it has always had a decreasing trend. In 1396 it reached about 22.0%, the lowest amount during 16 Last year. Comparing the economic share of rehabilitation of the country's economic activities with different countries shows that the position of this sector is in no way comparable to developed countries and is even lower than many developing countries. Tunisia, Tonga, and Moldova have a similar situation to Iran's economy, with rehabilitation services accounting for about 0.05 to 0.1 percent of their total economic activity. Comparison of the prevalence of disability in these countries with Iran shows that these countries had a lower prevalence than Iran. Examination of the share of various sources shows that out-of-pocket payments with households with 6.37 percent, the most, and the government with 7.18 percent had the least role in financing rehabilitation services. It is noteworthy that this figure was about 65% before implementing the health system transformation plan. Social insurance in 2017 also covered only 6.24% of rehabilitation costs. Conclusion: Inaccessibility of people with disabilities to healthcare services is a very serious issue in the world. The rehabilitation services expenditures have always been mentioned as one of the most important barriers of accessing to these services. Following the implementation of the Health Transformation Plan, the share of rehabilitation activities in Iran’s health market has been shrunk.

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