Obezbeđenost izabranim lekarima i njihova opterećenost u ustanovama primarne zdravstvene zaštite i po okruzima u republici srbiji

Abstract

Introduction/Aim: Determination and planning of a sufficient number of primary physicians is a prerequisite for high-quality primary health care. The aim of this paper was to determine the supply of primary physicians in the primary health care institutions and by districs in the Republic of Serbia in 2017, to analyze their workload and to compare the obtained values with the prescribed supply and workload. Methods: A secondary analysis of the supply and the workload of primary physicians in the health care services for adults, small and pre-school children, school children and women for 2017 was carried out in the public primary health care institutions (health centers and institutions) in the Republic of Serbia. The assessment of the supply and the workload of the primary physicians was made in relation to the values prescribed by the legislation. Results: In 2017, the supply of primary physicians in Serbia in the health care service for adults was higher than the prescribed one by 2% (1564 inhabitants per a physician), and higher by 13% (735 children per a physician) in the health care service for small and preschool children. There was a shortage of physicians, i.e. the supply of physicians in the health care service for women was lower than the prescribed one by 3% (6706 women per a physician) and by 9% (1630 school children per a physician) for the health care of school children. The supply that was more unfavorable than the prescribed one existed in 13 districts in the health care services for adults and women, in 7 districts in the health care service for small and pre-school children, and in 17 districts in the health care service for school children. The average daily workload of physicians was higher than the prescribed execution measures in the health care services for adults (36,5) and for children (30,6), and it was lower in the health care service for women (26,2), but it was at the prescribed level in the health care service for school children (30,0). The workload of physicians (expressed as the average number of visits per a physician) was higher than the prescribed one in 17 districts in the health service for adults, in 10 districts in the health care service for small and pre-school children, in 13 districts in the health care service for school children, in 6 districts in the health care service for women. Conclusion: There are great differences in the supply and workload of primary physicians by districts. It is necessary to ensure adequate human resource planning that takes into account both of these parameters and which will contribute to the advancement of personnel policies to reduce district disparities.