Implementing Funding Modalities for Free Access: The Case for a ‘Purchasing Fund System’ to Cover Medical Care for PLWHA

Abstract Background Access to health care is a key health policy issue faced by countries in the WHO European Region and Serbia is not an exception. There is increasing concern that financial and economic crisis may have delay progress regarding the performance of the Serbian health system. While substantial development has been experienced by the Serbian health system since 2000, we analyse whether barriers to health care access exist in the country and the underlying causes. Methods We combine quantitative and qualitative methods to assess the accessibility of the Serbian health system. We use the latest data available both at national (e.g. National Health Survey) and European (EUSILC) level to understand whether barriers to access exist and the underlying causes. On the qualitative side, we analyse the different policies implemented by the Serbian government to improve the accessibility of the health system in the last decade, identifying the challenges ahead for the country. Results We find that, in 2018, 5.8% of the Serbian population reported unmet need for medical care due to costs, travel distances or waiting lists, well above the EU28 average and much higher than in neighbouring countries. Financial constraints are reported to be the main reason for unmet needs for medical care. Long waiting times also impede the accessibility of health services in Serbia. Conclusions Serbia has a comprehensive universal health system with free access to health care, however, some vulnerable groups, such as those living in poverty or Roma people in settlements, have more barriers in accessing health care. It is expected that Serbia will continue to develop policies focused on reducing barriers to accessing health care and improving the efficiency of the health system, supported by international organisations and in the context of the EU accession negotiations. Key messages Some vulnerable groups have more barriers in accessing adequate care in Serbia. National initiatives are in place to increase access to the health system but there is scope for further work.

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Twinning and Birth Weight in the Israeli Jewish Versus Muslim Maternities

Twin Research ◽

10.1375/twin.5.1.15 ◽

2002 ◽

Vol 5 (1) ◽

pp. 15-18 ◽

Cited By ~ 3

Author(s):

Ran D. Goldman ◽

Ram Mazkereth ◽

Isaac Blickstein

Keyword(s):

Birth Weight ◽

Antenatal Care ◽

Medical Care ◽

Ethnic Differences ◽

Perinatal Outcome ◽

Perinatal Care ◽

Neonatal Care ◽

Entire Population ◽

Free Access ◽

Ethnicity Differences

AbstractEthnicity differences account for genetic, environmental, lifestyle, and reproductive variables, influencing the rate of twinning (Nylander, 1981). Frequently, ethnic differences correlate with variable perinatal care leading to differences in outcome. Free access to antenatal care, and to facilities for delivery and neonatal care is available for the entire population in Israel, and therefor differences attributed to levels of medical care are practically negligible. We previously evaluated the overall relationship between ethnicity and outcome in a popula-tion-based cohort of mothers of twins (Goldman et al., 2001). However, the overall comparison may have masked some differences that could be present. The purpose of this study was to evaluate whether ethnicity is associated with differences in perinatal outcome in randomly selected, matched-controlled Israeli Jewish and Muslim mothers of twins.

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Quality of medical care in Russia

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2021-99-5-6-383-387 ◽

2021 ◽

Vol 99 (5-6) ◽

pp. 383-387

Author(s):

G. В. Nazarenko

Keyword(s):

Medical Care ◽

Medical Practice ◽

Economic Activity ◽

Personal Responsibility ◽

Medical Community ◽

Free Access ◽

Provision Of Services ◽

Quality Of Medical Care ◽

Intended Effect

The system of providing medical care belongs to the sphere of economic activity referred to as «range of services» in Russia.The main criterion in the provision of services is the receipt of the final intended effect, which fully satisfies the customer of this service. If the final intended effect is not achieved, then this service cannot be considered as completed.In medical care, there is no final guaranteed result. The purpose of providing medical care is the very process of its provision.The intended result of treatment cannot be guaranteed, but the provider of medical care is obliged to apply all their experience and knowledge to achieve the most useful effect for the patient.Russian legislation provides for the evaluation of the quality of medical care based on the final effect. This approach to solving the issue of medical care improvement quality does not allow the healthcare in Russia to adequately develop since the main emphasis is placed on the administrative command system of control and motivation of doctors to their work. The openness of the medical community to the society leads to an inadequate evaluation of the inevitable medical failures, complications and problems in the field of medical treatment. The absence of medical practice institution in Russia and the prevalence of hired labor of doctors deprive the medical community of one of the main criteria for the development of medicine — the discretion, provided personal responsibility before a patient. In fact, it is impossible to receive high quality medical care under circumstances where a physician is only a hired "addition" to the material and technical base of a medical institution.The solution to the above problems can be found on condition of separating healthcare in Russia into a special sphere of economic activity with its own legal determination, structure, management, legislation. It is necessary to isolate medical community from society as much as possible, to limit free access to special information for public inspection and non-expert accusations. We should rely on the development of medical practice in the country as it fullestly reflects doctor's competence independent on the will of the employer.

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New premises and new tools for medical care and education

Journal of Dental Education ◽

10.1002/j.0022-0337.1996.60.1.tb03013.x ◽

1996 ◽

Vol 60 (1) ◽

pp. 64-67

Author(s):

LL Weed

Keyword(s):

Medical Care

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The Collaborative Medical and Behavioral Management of Chronic Cough

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd19.2.49 ◽

2009 ◽

Vol 19 (2) ◽

pp. 49-57

Author(s):

Brian E. Petty ◽

Seth H. Dailey

Keyword(s):

Medical Care ◽

Chronic Cough ◽

Therapeutic Management ◽

Ambulatory Setting ◽

Behavioral Management ◽

Speech Language Pathologists ◽

Speech Language Pathologist ◽

The Many ◽

Frequent Reason

Abstract Chronic cough is the most frequent reason cited by patients for seeking medical care in an ambulatory setting and may account for 10% to 38% of a pulmonologist's practice. Because chronic cough can be caused by or correlated with a wide array of disorders and behaviors, the diagnosis of etiologic factors and determination of appropriate therapeutic management in these cases can prove to be daunting for the physician and speech-language pathologist alike. This article will describe the phenomenon of chronic cough, discuss the many etiologic factors to consider, and review some of the more common ways in which speech-language pathologists and physicians collaborate to treat this challenging condition.

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