National Health Financing Research Articles

Финансирование национальной системы здравоохранения с учетом тенденций развития медицинской помощи и социально-экономических реалий

The effectiveness of the functioning of the health care system consists in achieving high indicators of the quality of life of the population, which is achieved through the use of various regulatory and self-regulation tools in the health care system, which are always based on the need for financial support, which is the cornerstone of solving problems related to the need to increase the effectiveness of the health protection system. The financing of the healthcare system is considered from the point of view of its compliance with modern socio-economic realities. The optimal model of financing the domestic healthcare system is being investigated in terms of the relationship between the life expectancy of the population, the amount of financing for the health protection system, the number of medical institutions and the availability of medical personnel. The priority directions of the development of the national health financing system are substantiated. It is concluded that the national model for financing the health protection system should be a model based on the allocation of funds from the federal budget, which are directed to ensuring the financing of programs for the development of the national health system, as well as based on the creation of institutional, legislative and mental conditions for attracting public funds to the insurance industry medicine. It is confirmed that there is a close relationship between the effective indicator of life expectancy and public spending on health, which corresponds to WHO statistics. Other factors do not have such a strong impact on the national health system. It is recommended to further develop the healthcare financing system based on foreign experience, on the development of insurance and paid medicine.

The Role of Supplementary Insurance in Achieving Universal Health Coverage: A Comprehensive Review.

The gradual movement towards universal health coverage (UHC) is an important issue in many countries. The aim of this study is to identify the role of supplementary health insurance in achieving universal coverage. This comprehensive review study was conducted to identify the role of supplementary health insurance in achieving universal health coverage. 4894 articles were found in the search in databases (Scopus, PubMed, and Web Science), and finally42 articles were selected. Considering the criteria of titles and abstracts, the reviewed articles were assessed, and a thematic analysis approach was used to analyze the collected data. The review showed 52 Sub dimensions in 7 dimensions. Policymakers can draw on international experiences to ensure that private health insurance contributes to achieving universal health coverage by Providing clarity within the national health financing policy framework regarding the role of private health insurance. Enhancing understanding of how supplementary health insurance impacts the performance of the healthcare system. They are improving oversight of private health insurance, regulating financial protection and consumer support, and implementing thorough market surveillance and proper allocation of health subsidies between the private and public sectors. Supplementary insurance holds promise as a complementary tool in achieving universal health coverage. Addressing gaps in primary insurance and providing additional financial protection can contribute to enhanced access, improved quality of care, and reduced financial barriers to healthcare services. However, careful attention must be given to affordability, equity, regulation, and coordination with primary insurance schemes to ensure its effective implementation and prevent unintended consequences.

Health financing policies during the COVID-19 pandemic and implications for universal health care: a case study of 15 countries

The COVID-19 pandemic was a health emergency requiring rapid fiscal resource mobilisation to support national responses. The use of effective health financing mechanisms and policies, or lack thereof, affected the impact of the pandemic on the population, particularly vulnerable groups and individuals. We provide an overview and illustrative examples of health financing policies adopted in 15 countries during the pandemic, develop a framework for resilient health financing, and use this pandemic to argue a case to move towards universal health coverage (UHC). In this case study, we examined the national health financing policy responses of 15 countries, which were purposefully selected countries to represent all WHO regions and have a range of income levels, UHC index scores, and health system typologies. We did a systematic literature review of peer-reviewed articles, policy documents, technical reports, and publicly available data on policy measures undertaken in response to the pandemic and complemented the data obtained with 61 in-depth interviews with health systems and health financing experts. We did a thematic analysis of our data and organised key themes into a conceptual framework for resilient health financing. Resilient health financing for health emergencies is characterised by two main phases: (1) absorb and recover, where health systems are required to absorb the initial and subsequent shocks brought about by the pandemic and restabilise from them; and (2) sustain, where health systems need to expand and maintain fiscal space for health to move towards UHC while building on resilient health financing structures that can better prepare health systems for future health emergencies. We observed that five key financing policies were implemented across the countries-namely, use of extra-budgetary funds for a swift initial response, repurposing of existing funds, efficient fund disbursement mechanisms to ensure rapid channelisation to the intended personnel and general population, mobilisation of the private sector to mitigate the gaps in public settings, and expansion of service coverage to enhance the protection of vulnerable groups. Accountability and monitoring are needed at every stage to ensure efficient and accountable movement and use of funds, which can be achieved through strong governance and coordination, information technology, and community engagement. Our findings suggest that health systems need to leverage the COVID-19 pandemic as a window of opportunity to make health financing policies robust and need to politically commit to public financing mechanisms that work to prepare for future emergencies and as a lever for UHC. Bill & Melinda Gates Foundation.

The impact of COVID-19 on health financing in Kenya.

Sudden shocks to health systems, such as the COVID-19 pandemic may disrupt health system functions. Health system functions may also influence the health system's ability to deliver in the face of sudden shocks such as the COVID-19 pandemic. We examined the impact of COVID-19 on the health financing function in Kenya, and how specific health financing arrangements influenced the health systems capacity to deliver services during the COVID-19 pandemic.We conducted a cross-sectional study in three purposively selected counties in Kenya using a qualitative approach. We collected data using in-depth interviews (n = 56) and relevant document reviews. We interviewed national level health financing stakeholders, county department of health managers, health facility managers and COVID-19 healthcare workers. We analysed data using a framework approach. Purchasing arrangements: COVID-19 services were partially subsidized by the national government, exposing individuals to out-of-pocket costs given the high costs of these services. The National Health Insurance Fund (NHIF) adapted its enhanced scheme's benefit package targeting formal sector groups to include COVID-19 services but did not make any adaptations to its general scheme targeting the less well-off in society. This had potential equity implications. Public Finance Management (PFM) systems: Nationally, PFM processes were adaptable and partly flexible allowing shorter timelines for budget and procurement processes. At county level, PFM systems were partially flexible with some resource reallocation but maintained centralized purchasing arrangements. The flow of funds to counties and health facilities was delayed and the procurement processes were lengthy. Reproductive and child health services: Domestic and donor funds were reallocated towards the pandemic response resulting in postponement of program activities and affected family planning service delivery. Universal Health Coverage (UHC) plans: Prioritization of UHC related activities was negatively impacted due the shift of focus to the pandemic response. Contrarily the strategic investments in the health sector were found to be a beneficial approach in strengthening the health system. Strengthening health systems to improve their resilience to cope with public health emergencies requires substantial investment of financial and non-financial resources. Health financing arrangements are integral in determining the extent of adaptability, flexibility, and responsiveness of health system to COVID-19 and future pandemics.

Gatekeepers in the health financing scheme: Assessment of knowledge, attitude, practices, and participation of Malaysian private general practitioners in the PeKa B40 scheme.

This is cross-sectional research done to assess the readiness of the private Malaysian general practitioners (GPs) for the implementation of the national health financing scheme. The study focused on their levels of knowledge and attitudes towards the types of health financing scheme, gatekeeper roles in the health financing scheme, and their participation in the PeKa B40 scheme. Their acceptance and level of participation in the national health financing scheme (NHFS) were also assessed. A set of self-designed and pre-tested questionnaires focusing on the aforementioned objectives were mailed to the respondents. The selection of respondents was done by stratified random sampling of the GPs in all 14 Malaysian states at both urban and rural levels. Out of a calculated number of 362 GPs targeted, 296 responses were received which represented a response rate of 81.7%. The respondents had a mean age of 50.7 years 165 (55.75%) were males and 131 (44.3%) were females. The rural respondents totalled 158 (53.4%) as compared to those from urban 138 (46.6%) areas. The outcomes observed were that GPs with PeKa B40 provider status, positive attitude towards health financing schemes, gatekeeper roles, and PeKa B40, were strongly associated with their acceptance and level of participation in the NHFS. The GPs possessed a positive attitude and were generally ready to participate in the NHFS, but the lower scores in knowledge levels would require definite education and training plans to further enhance their readiness. More incentives should be given to GPs to enrol as PeKa B40 providers. The results of this study should be strongly considered by the government in the efforts to engage the Malaysian private GPs in the forthcoming NHFS. Most importantly, the role of GPs as gatekeepers needed to be implemented, and the PeKa B40 scheme be greatly improved.

Family planning saves maternal and newborn lives: Why universal access to contraception must be prioritized in national maternal and newborn health policies, financing, and programs.

SynopsisWe highlight why integrating contraceptive services within maternal and newborn health programs is essential for improving outcomes. We offer effective, actionable recommendations that can be implemented easily.

HUBUNGAN KEPATUHAN MINUM OBAT TERHADAP KONTROL TEKANAN DARAH PASIEN HIPERTENSI DI PUSKESMAS MANGGIS PROVINSI BALI

Hypertension is a chronic disease that requires long-term treatment. This has an impact on the size of national health financing. In an effort to anticipate costs related to complications, it is necessary to evaluate treatment adherence in the short and long term. This study aims to analyze the relationship between medication adherence and blood pressure control as a short-term outcome of hypertension management at the primary care level. The research method uses a cross sectional design. The research was conducted at the Manggis Health Center with a total sample of 32 people. The sampling technique used is purposive sampling. The measurements used demographic questionnaires, observation sheets for blood pressure checks, and the MMAS-8 questionnaire in Indonesian. Statistical test resultsusing Chi square found p = 0,016 (p<0,05) so there is a relationship between medication adherence and blood pressure control in hypertensive patients. The therapeutic effect of ACE inhibitor and calcium channel blocker directly make the blood vessels relax and wider. The characteristics of hypertensive patients at the Manggis Health Center are mostly the elderly population, women, most do not smoke, and do not have comorbid diabetes. However, proactive prognosis projection is needed. The conclusion in this study is that there is a relationship between medication adherence and blood pressure control in hypertensive patients at the Manggis Health Center.

Review on the Reflection of National Health Financing Policy and Strategy on Nigerians towards Achieving Universal Health Coverage by 2030

Labour pain management is crucial for a comfortable childbirth experience. A range of options, including epidural anesthesia, breathing techniques, massage and positional changes, are available for managing labour pain. Factors such as maternal preference, stage of labour and medical conditions are considered when choosing the right approach. Effective labour pain management benefits both the mother and baby. This systematic review is aimed to identify best practices and gaps in managing labour pain and to provide recommendations for a comprehensive and effective capacity building program. The review analyzed relevant literature and data sources to assess the current state of midwifery education and practice in labour pain management. The results of the review indicate a need for a comprehensive and multi-faceted capacity building program that includes hands-on training, mentorship, and ongoing professional development opportunities for midwives. The study concludes that a well-designed and well-implemented capacity building program on labour pain management can improve the quality of care for mothers and newborns and enhance the competencies of midwives in Ekiti State.

Medication adherence and blood pressure control: A preliminary assessment of the role of health insurance in Nigeria and Ghana.

This study sought to assess the current impact of health insurance coverage on medication adherence and blood pressure control of patients being managed for hypertension in Ghana and Nigeria. The study was a prospective study among 109 patients with hypertension in two health facilities with similar population dynamics in Ghana and Nigeria. Patients were systematically selected, categorized as having health insurance coverage or not, and followed up monthly for 6 months. The outcome variables (medication adherence and blood pressure control) were then measured and compared at 6 months. Analysis was done using Stata with level of significance set at p ⩽ 0.05. There was a 90% insurance coverage among participants from Ghana compared to 15% from Nigeria. National Health Insurance Authority enrolees in both countries had better blood pressure control and medication adherence compared to non-enrolees (adjusted odds ratio = 2.6 and 4.5, respectively). National Health Insurance Authority enrolment was found to be poor among respondents in Nigeria compared to Ghana. Enrolment into the National health financing schemes in both countries led to better blood pressure control and medication adherence among patients with hypertension at primary health facilities. There is therefore the need for system strengthening to improve their sustainability.

Breast Cancer in Indonesia in 2022: 30 Years of Marching in Place

Breast Cancer in Indonesia in 2022: 30 Years of Marching in Place

Availability of essential diagnostics in the Philippines

Availability of essential diagnostics in the Philippines

NATIONAL HEALTH FINANCING SYSTEMS AGAINST THE BACKDROP OF A GLOBAL PANDEMIC: NEW CHALLENGES AND PROSPECTS.

The aim: The purpose of the article is to study the challenges and prospects for the development of national health financing systems against the background of a pandemic. Materials and methods: Our research consists of two interrelated stages. At the first stage, the central task was to determine the size of the drop in world GDP. In the second part of the study, we focused on the definition of the essence of concession agreements in order to use t in the field of medical care. The key methods used in this study were data analysis, generalization, and comparison. Conclusions: National health financing systems in the vast majority of the world's countries have experienced unprecedented pressures and problems both in terms of health insurance due to the huge losses of the insurance industry in 2020. In order to improve health care financing systems, it is necessary to update the forms, methods and tools of the insurance market functioning in terms of the health insurance segment, and to introduce new mechanisms for financing the medical sector in the process of combating the spread of coronavirus infection.

Analysis of the trends of polypharmacy and high-dose prescriptions in Japan.

IntroductionAfter extensive research, this study explored whether high‐dose prescriptions and polypharmacy remain more frequent in Japan than elsewhere. If confirmed, we aimed to identify the factors that contributed to this unique trend.MethodsThe psychotropic drug prescription patterns for patients with schizophrenia in Japan were reviewed. This was based on a large sample collected from surveys of the Research on Asian Psychotropic Prescription Patterns, an international collaborative research project conducted by Asian psychiatrists to monitor prescriptions of psychotropic drugs for people with mental disorders, in 2001, 2004, 2008, and 2016.ResultsThe 2016 Research on Asian Psychotropic Prescription Patterns survey revealed that Japan continued to demonstrate the highest rate of polypharmacy and the highest dosages of psychotropic prescription drugs for patients with schizophrenia among the 15 countries and areas that participated in the survey.DiscussionThe Research on Asian Psychotropic Prescription Patterns surveys demonstrated that science plays a limited role in the decision‐making process for prescriptions of psychotropic medications. Such prescriptions are influenced by a wide range of factors, such as the national mental health policy, prescription‐financing systems, the history of psychiatry in each country, and the prevailing culture. Hospital‐based national mental health policies and mental health financing systems have been the primary obstacles to reducing polypharmacy in Japan.

Maternal mortality ratio in China from 1990 to 2019: trends, causes and correlations

BackgroundMaternal mortality ratio is an important indicator to evaluate the health status in developing countries. Previous studies on maternal mortality ratio in China were limited to certain areas or short periods of time, and there was a lack of research on correlations with public health funding. This study aimed to assess the trends in the maternal mortality ratio, the causes of maternal death, and the correlations between maternal mortality ratio and total health financing composition in China from 1990 to 2019.MethodsData in this longitudinal study were collected from the China Health Statistics Yearbooks (1991–2020) and China Statistical Yearbook 2020. Linear regression analysis was used to assess the trends in the maternal mortality ratio in China. Pearson correlation analysis was used to assess the correlations between national maternal mortality ratio and total health financing composition.ResultsThe yearly trends of the national, rural and urban maternal mortality ratio were − 2.290 (p < 0.01), − 3.167 (p < 0.01), and − 0.901 (p < 0.01), respectively. The gap in maternal mortality ratio between urban and rural areas has narrowed. Obstetric hemorrhage was the leading cause of maternal death. The mortalities ratios for the main causes of maternal death all decreased in China from 1990 to 2019. The hospital delivery rate in China increased, with almost all pregnant women giving birth in hospitals in 2019. Government health expenditure as a proportion of total health expenditure was negatively correlated with the maternal mortality ratio (r = − 0.667, p < 0.01), and out-of-pocket health expenditure as a proportion of total health expenditure was positively correlated with the maternal mortality ratio (r = 0.516, p < 0.01).ConclusionChina has made remarkable progress in improving maternal survival, especially in rural areas. The maternal mortality ratio in China showed a downward trend over time. To further reduce the maternal mortality ratio, China should take effective measures to prevent obstetric hemorrhage, increase the quality of obstetric care, improve the efficiency and fairness of the government health funding, reduce income inequality, and strengthen the medical security system.

Towards a needs-based design of the physical rehabilitation workforce in South Africa: trend analysis [1990\u20132017] and a 5-year forecasting for the most impactful health conditions based on global burden of disease estimates

BackgroundRehabilitation can improve function in many people with chronic health conditions. It is important to consider priority conditions requiring rehabilitation, so it can be realistically positioned and costed in national health financing systems like South Africa (SA)‘s proposed National Health Insurance (NHI). This paper describes temporal trends of top-ranked conditions on years lived with disability (YLDs) rates in SA, for which physical rehabilitation can ameliorate associated disability.MethodsThis study is a systematic synthesis of publicly available Global Burden of Disease (GBD) 2017 estimates. The top 11 conditions contributing most to YLDs and for which evidence-based rehabilitation interventions exist were identified. Age-standardized rates per 100,000 and YLDs counts were extracted from 1990 to 2017. Significance of changes in temporal trends was determined using Mann-Kendall trend tests. Best-fit rates of yearly changes were calculated per condition, using GBD estimates (2012–2017), and extrapolated (by imposing the best-fit regression line onto results for each subsequent predicted year) as forecasts (2018–2022).ResultsTrends for YLDs counts per condition year (1990–2017) and forecasted values (2018–2022) showed an overall steady increase for all conditions, except HIV and respiratory conditions. YLDs counts almost doubled from 1990 to 2017, with a 17% predicted increase from 2017 to 2022. The proportionate contribution to YLDs counts reduced over time for all conditions, except HIV. Although age-standardized YLDs rates appear relatively stable over the analyzed periods for all conditions (except HIV, respiratory conditions and type 2 diabetes), trend changes in YLDs rates over 28 years were significant for all conditions, except neonatal (p = 0.855), hearing loss (p = 0.100) and musculoskeletal conditions (p = 0.300). Significant trend decreases were apparent for 4/9 conditions, implying that another 5/9 conditions showed trend increases over 28 years. Predicted all-age prevalence in 2022 suggests relatively large increases for cardiovascular disease and heart failure, and burns, while relative decreases are predicted for fractures and dislocations, stroke, and musculoskeletal conditions.ConclusionRehabilitation needs in SA are potentially massive and unmet, highlighting the need for innovative and context-specific rehabilitation that considers current local needs and projected changes. These findings should be considered when designing the NHI and other schemes in SA to ensure human and financial resources are deployed efficiently.

Influence of service quality on consumer loyalty: a mediation analysis of health insurance

PurposeThis study aims to examine the influence of service quality (SQ) on customer loyalty (CL) and the mediating role of customer satisfaction (CS) and customer perceived value (CPV) in health insurance products in Malaysia.Design/methodology/approachData were conveniently collected through a self-administered questionnaire from subscribers to health insurance products and services in Malaysia. A total of 456 available questionnaires were used in the analysis. Partial least square (PLS) structural equation modelling (V3.3) was used to obtain the study results.FindingsA positive relationship is observed amongst the studied variables. In addition, CPV partially mediates the proposed relationship and also indirectly mediates the relationship between SQ and CS. Lastly, CS partially mediates the proposed relationship. Hence, all proposed direct and indirect relationships are significant and positive.Research limitations/implicationsThis research increases the authors’ understanding of the role of CS, SQ and CPV on CL in the health insurance industry in a developing country. The study also shows that insurance companies must establish positive relationships between insurers and customers by providing excellent SQ to maintain CS and loyalty.Practical implicationsThis research will help managers and guide the policymakers to establish a national health financing scheme. Furthermore, these results will guide industry players on how to maintain existing and targeting customers.Social implicationsThis study has attempted to provide a comprehensive understanding of CL in the Malaysian health insurance industry. Considering the limited research in the Malaysian health insurance context, this study can provide theoretical contribution and a managerial basis for future studies, including implications for the managers. However, to date, research in this sector under the Malaysian context is not adequate to consider SQ, perceived values and CL factors.Originality/valueThis study has attempted to provide a comprehensive understanding of CL in the Malaysian health insurance industry. Considering the limited research in the Malaysian health insurance context, this study can provide theoretical contribution and a managerial basis for future studies, including implications for the managers.

Assessing progress in the national health financing system towards universal health coverage in Iran: a mixed-method study protocol

IntroductionHealth financing systems have a key role in achieving universal health coverage (UHC) across the globe. However, little is known about how best to monitor health financing system progress towards UHC, especially in low- and middle-income countries. This is a protocol of a study that will aim to assess health financing system progress towards achieving UHC in Iran.MethodsAn explanatory mixed-method approach will be used in two phases. In the quantitative phase, the performance of the Iranian health financing system will be assessed using a well-established set of indicators to draw on progress over 5-year intervals starting in the year 2000 up to the present. Data will be extracted from the global health expenditure database using a specific form and will be classified in accordance with each indicator. A qualitative phase will then take place considering the Kutzin et al. framework and by using health financing progress matrices. The qualitative phase will consist of two successive stages; first, a descriptive overview on the major health coverage schemes along with key attributes of each scheme. This initial mapping will be the underlying background for the second stage. In the second stage, the matrices comprised of a series of questions and relevant to the core functions of health financing and cross-cutting options will be invested in enhancing the evaluation of the ongoing reforms or policies. In this phase, data will be collected by reviewing national policy documents and in-depth interviews with key informants who will be recruited using purposive sampling. Finally, a policy discussion with key stakeholders will be held in order to review and verify the consistency between the current health financing policy and UHC goals.DiscussionThis study will provide a comprehensive image about the current status of the national health financing system progress towards achieving UHC in Iran. Such assessment will give detailed insight about the performance of the current financing system through identifying encountered challenges. Furthermore, some other defects in the design of the financing system are expected to appear. In all likelihood, the results will be fruitful enough to make informed decisions about interventions and policies in relation to UHC.Ethics and disseminationThe study protocol has been approved by the Ethics Committee for Research at Tehran University of Medical Sciences. Informed consent will be obtained from all key informants and the data will be collected and transcribed anonymously in order to maintain utmost confidentiality. The results will be disseminated in peer-reviewed journals and presented in national and international conferences and meetings.

TRANSFIGURATION OF NATIONAL HEALTH FINANCING TO RURAL COMMUNITIES

Health financing is one of the important goals of any government. In Kenya, the government is exerting all effort to ensure its citizens’ health care needs are safeguarded through increased budgeting and putting in place requisite legislative measures. However, like any other developing nation, the dream of equity in accessing health care is not satisfactorily realized due to many challenges. For pastoralist/nomadic communities in the country, who are deemed marginalized in a considerable number of spheres relative to communities subscribing to other subsistence strategies, the solution is far from being hoped for. This research asks the question “how can national health financing be transfigured to suit the need of pastoral-nomadic communities?”. The research adopted descriptive research design to survey household in the four constituencies of Marsabit County. Respondents were selected using random sampling. Structured questionnaire and focused group discussion was used to gather data and using logistic regression. Many of them do not have a formal education and hence formal employment to enable them have consistent income to pay for their health cover forcing them depend on donors. It was recommended that education should be enhanced so as to upscale the enrolment to health insurance. Further, they should be encouraged to join to a welfare group so as to access finances for payment of insurance subscription. The government should diversify mode of payment and also mobilize resources that will be used to help the poor pay for their health financing need.

Policy dialogue and participation: a new way of crafting a national health financing strategy in Morocco

BackgroundPolicy dialogue for health policies has started to gain importance in recent years, especially for complex issues such as health financing. Moroccan health financing has faced several challenges during the last years. This study aims to document the Moroccan experience in developing a consolidated health financing strategy according to the policy dialogue approach. It especially considers the importance of conceptualising this process in the Moroccan context.MethodWe documented the process of developing a health financing strategy in Morocco. It concerned four steps, as follows: (1) summarising health financing evidence in preparation of the policy dialogue; (2) organising the health policy dialogue process with 250 participants (government, private sector, NGOs, civil society, parliamentarians, technical and financial partners); (3) a technical workshop to formulate the strategy actions; and (4) an ultimate workshop for validation with decision-makers. The process lasted 1 year from March 2019 to February 2020. We have reviewed all documents related to the four steps of the process through our active participation in the policy debate and the documentation of two technical workshops to produce the strategy document.ResultsThe policy dialogue approach showed its usefulness in creating convergence among all health actors to define a national shared vision on health financing in Morocco. There was a high political commitment in the process and all actors officially adopted recommendations on health financing actions. A strategy document produced within a collaborative approach was the final output. This experience also marked a shift from previous top-down approaches in designing health policies for more participation and inclusion. The evidence synthesis played a crucial role in facilitating the debate. The collaborative approach seems to work in favouring national consensus on practical health financing actions.ConclusionThe policy dialogue process adopted for health financing in Morocco helped to create collective ownership of health financing actions. Despite the positive results in terms of national mobilisation around the health financing vision in Morocco, there is a need to institutionalise the policy dialogue with a more decentralised approach to consider subnational specificities.

Kretanje troškova zdravstvene zaštite u Srbiji

Healthcare system has an important role in the contemporary countries' economic development. Health expenditures are affected by many economic, as well as noneconomic factors. The importance of health and health system financing is particularly evident in the circumstances of the COVID-19 coronavirus pandemic, which caused a significant increase in unforeseen heath expenditures, as well as the emergence of fiscal deficit in many countries around the world. The purpose of this paper is to provide insight into the trend of the most important health spending indicators in Serbia in the period from 2012 to 2017. The paper concludes that in addition to the reform of the national health financing system, the Serbian Government should implement austerity measures to make health expenditures more sustainable.