Analiza izvora finansiranja zdravstvenih sistema zemalja u sastavu bivše Jugoslavije

Abstract

Objective. The aim of this study was to analyse health expenditure between 2011 and 2015 in the chosen countries by using National Health Account indicators, and comparing financial health indicators between these countries. The study explains the structure of health systems in the countries and their sources of funding by using System of Health Accounts methodology. Methods. A retrospective analysis of health financing indicators in Bosnia and Herzegovina, Montenegro, Macedonia, Slovenia, Serbia and Croatia has been carried out. The World Health Organization's Global Health Expenditure database and the Health for All database were used for the analysis, in accordance with the methodology of the System of Health Accounts SHA 2011 - Organization for Economic, Cooperation and Development, System of Health Account, Version SHA 2011. Results. The obtained results showed that Bosnia and Herzegovina and Serbia had the same level of current health expenditure of 9.4% of GDP on average, in the period 2010- 2015, while in Montenegro and Macedonia this share was significantly lower (6% and 6.1% of GDP). Bosnia and Herzegovina, Montenegro and Serbia recorded similar levels of per capita current health expenditure, while Macedonia had the lowest expenditure, and the highest was in Slovenia. Public sector health expenditure as a share of GDP was the highest in Bosnia and Herzegovina (6.7%), and the lowest in Montenegro. Private consumption is predominantly based on pocket consumption and the highest out-of-pocket expenditure as a share of GDP is in Serbia (3.9%), Bosnia and Herzegovina (2.8%) and the lowest is in Slovenia and Croatia (1.1%). Bosnia and Herzegovina and Montenegro had similar levels of out-ofpocket expenditure per capita, which range in value of 315 and 305 PPPs on average for the six observed years. The reasons for the differences in the results of public expenditure in the observed countries and the reasons that can lead to unsustainable health systems have been explained. Conclusion. The obtained results will help to better understand the structure of health care financing systems in Bosnia and Herzegovina, Montenegro and neighbouring countries, and the need to develop the National Health Account for better monitoring and comparison of the health expenditure and health systems between the countries.