Abstract

The health care system in Albania, as in all other ex-communist countries of Central and Eastern Europe (CEE), is rooted in the Soviet “Semashko” model. The legacies of the Semashko system still remain visible especially in the state ownership of public healthcare institutions, public provision of the services, as well as the funding from the general tax base (especially for secondary and tertiary care) (1). WHO data show that in 2013, the total health care expenditure for the country amounted to 5.9% of its GDP (2). This is relatively high compared to other former communist CEE or Former Soviet Union (FSU) countries, but still much lower than the average 8.5% for the EU15 countries (2). However, only about 48.4% of the total health care spending in Albania comes from the general state budget (2), and the share of private expenditures and out-of-pocket expenditures is relatively high (3). The utilization of health insurance in Albania remains low (4). In addition to this, almost 19% of all patients visiting outpatient services and almost 44% of patients visiting inpatient services in 2008 pay informally as well (5). But, are out-of-pocket and informal payments in Albania catastrophic to households’ budgets? If yes, what are their effects on poverty? And more importantly, what are the main policy implications for a fast-developing country like Albania?

Highlights

  • The health care system in Albania, as in all other ex-communist countries of Central and Eastern Europe (CEE), is rooted in the Soviet “Semashko” model

  • Only about 48.4% of the total health care spending in Albania comes from the general state budget [2], and the share of private expenditures and out-of-pocket expenditures is relatively high [3]

  • After the change of regime, the main reforms were focused in primary health care (PHC) and have sought to transfer the financing of the sector to the Health Insurance Institute (HII), which was established in 1994

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Summary

Frontiers in Public Health

WHO data show that in 2013, the total health care expenditure for the country amounted to 5.9% of its GDP [2]. This is relatively high compared to other former communist CEE or Former Soviet Union (FSU) countries, but still much lower than the average 8.5% for the EU15 countries [2]. Only about 48.4% of the total health care spending in Albania comes from the general state budget [2], and the share of private expenditures and out-of-pocket expenditures is relatively high [3]. Are out-of-pocket and informal payments in Albania catastrophic to households’ budgets?

The Health System in Albania
Formal and Informal Payments in Albania
Expenditures in ALL
Findings
Policy Implications

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