Slovenian Health Research Articles

Cost-effectiveness of tick-borne encephalitis vaccination in Slovenian adults

BackgroundSlovenia is an endemic country with a high incidence rate of tick-borne encephalitis (TBE) and low vaccination coverage. TBE causes high costs for the health care insurances as well as the society due to hospitalization and frequent long term or permanent neurological sequelae. Vaccination is effective and a safe prophylaxis against TBE. ObjectiveThe purpose of this study was to evaluate the incremental cost-effectiveness ratio (ICER) between vaccination and no vaccination in Slovenia. The results are shown as cost per quality-adjusted life year (QALY) gained from the view of the health care payer and the society. MethodsBased on the natural course of the disease, the Markov model was used for comparing the economic and health outcomes of vaccinated and unvaccinated groups from 18 to 80 years of age. ResultsThe incremental cost-effectiveness ratio from the current Slovenian vaccination programme for FSME-Immun® compared to no vaccination amounts to €15,128 per QALY gained and for Encepur® €20,099 per QALY gained from the view of the health care payer. From the view of the society vaccination is cost saving, mainly due to avoiding the high indirect costs. ConclusionsAccording to the cost-effectiveness threshold as proposed by the Slovenian Health Council, the current Slovenian vaccination programme against TBE is cost-effective from the health care payer's perspective and also economical from the society's perspective.

Erasmus exchange in the field of family medicine in Slovenia

The purpose of this paper is to analyze the Erasmus exchange of students at the University of Ljubljana, Department of family medicine in the period from 2005 to 2010. The beginnings of an Erasmus exchange in the field of family medicine in Europe are described. Ljubljana Medical School has currently 60 bilateral agreements with universities or medical faculties in the EU and EFTA countries. We collected data of all students who come from the foreign faculties to the Department of family medicine and those from Slovenia who went to study abroad. In addition to basic descriptive statistics, we used the elements of qualitative analysis, where we reviewed the reports of the Slovenian Erasmus students, who went on exchange in the field of family medicine. Department of family medicine cooperated with 14 foreign medical schools since 2005. 42 Slovenian students went on academic exchange in the field of family medicine. 21 foreign students came to Department of family medicine in Ljubljana. Female students were more frequent in exchange compared with male students. The largest proportion of students went abroad in 2009. Most foreign students visited Department of Family medicine in Ljubljana in 2011. Reports of students show that they learned a lot. Students were able to compare the organization of health care in a foreign country and Slovenian health care system. Erasmus exchange has proven to be an important addition to the existing educational system. Students are acquainted with the progress of health care in Europe in this way. They are able to compare the benefits and disadvantages of foreign health care systems with home health care organization.

Perceptions of a client-centred approach among Slovenian occupational therapists

Aims: The aim of the study was to explore how Slovenian occupational therapists use a client-centred approach in their current clinical practice. Method: A generic qualitative approach was selected and twelve semi-structured interviews were completed to gain a deeper understanding of the use of a client-centred approach used by occupational therapists in the Slovenian health care system. A thematic analysis was used to analyse the data and identify the participants’ experiences. Findings: The majority of the participants perceived that the use of a client-centred approach was beneficial to the occupational therapy process. While they experienced factors that would facilitate the use of this approach they also identified challenges to implementation in their own practice settings. Their experience of the Slovenian health care system was that it was still strongly influenced by the medical model. Conclusions: All the participants expressed a willingness to incorporate a client-centred approach in their practice. They all identified the motivation of the individual occupational therapist and their willingness to undertake further education as essential. This study will inform and influence the development of this approach in occupational therapy practice in Slovenia.

Differentiating Between Rights-Based and Relational Ethical Approaches

When forced treatment in mental health care is under consideration, two approaches guide clinicians in their actions: the dominant rights-based approach and the relational ethical approach. We hypothesized that nurses with bachelor's degrees differentiate better between the two approaches than nurses without a degree. To test this hypothesis a survey was performed in major Slovenian health institutions. We found that nurses emphasize the importance of ethics and personal values, but 55.4% of all the nurse participants confused the two approaches. The results confirmed our hypothesis and indicate the importance of nurses' formal education, especially when caring for patients with mental illness.

Constitutional Review of the Slovenian Health Law

AbstractThe development of the modern Slovenian Health Law was first urged by the adoption of a new Constitution in the year 1991. Since then the Jurisprudence of the Constitutional Court has played a noticeable role by assuring the effective protection of Human Rights in the field of Health Law Legislation, which includes about thirty statutes. In several cases the Constitutional Court had to annul some parts of Health Legislation because they were not in accordance with the Constitution. The constitutional review of the Constitutional Court has been a very important factor in building and improving the Slovenian Health Law. Its jurisprudence can be regarded as one of the main causes for a comprehensive Health Law Reform which started in the year 2006.

Admission of new oncological drugs to the Slovenian health care system and their accessibility to the patients

Background: The aim of the present study is to analyze the admission of anticancer drugs to the Slovenian healthcare system, and to evaluate patients’ accessibility to these medications. Methods: Admission and accessibility to anticancer drugs was evaluated by analysing: differences in registration time among USA, selected member states of EU, and Slovenia; time from the registration to the first use in Slovenia; differences between the first use in Slovenia and the first use in selected member states of EU and by analysing the market of oncology drugs. The study included drugs of the ATC groups such as Antitumor medications (cytostatics) (ATC = L01) and Endocrine treatment (ATC = L02) that were used in Slovenia for the first time between 1999 to 2005. Registration data for Slovenia and EU was obtained from the registration documention of selected drugs at the Agency for Medicinal Products and Medical Devices of the Republic of Slovenia, and the European Agency for the Evaluation of Medicinal Products (EMEA). Registration data for USA was obtained from the registration documention of selected drugs at the Food and Drug Administration (FDA). The information upon the first use of drugs in Slovenia was acquired from the PharMIS system, and the information upon the first use of drugs in selected member states of EU was obtained from the study on patients’ access to oncology drugs by Nils Wilking and Bengt Jonsson, performed from 2005. Data for the market analysis of oncology drugs was obtained from the PharMIS system. Results: In previous years a delay in registration time between Slovenia and compared states was present for some oncology drugs. Along with the acceptance of Slovenia as a new member state of EU, on 1st May 2004, registration process in Slovenia became a part of the registration system of the European Agency for the Evaluation of Medicinal Products (EMEA). Majority of drugs had a time difference between the registration and the first use shorter than 10 months. Exceptions are drugs which were first used, mostly in a limited amount, before the acquisition of trade permit in Slovenia or through centralized procedure at EMEA such as oxaliplatin, irinotecan, capecitabine, imatinib mesylate. Average difference between the first use in Slovenia and selected member states of EU for the chosen oncology drugs decreased with years. In recent period oncology drugs were more quickly accessed by patients than in the past. The drug market continuously increased from 1999 to 2005, with an average increase of 30 M EUR per year. The largest increase was demonstrated for the antitumor medications and imunomodulators (ATC = L). In 1999 their market amounted to 10 M EUR or 3.9 % of the whole drug market, in 2005 it amounted to 38 M EUR or 8.6 % of the whole drug market. The market of the targeted drugs has been progressively increasing from year 2000 onwards, and amounted to 6 M EUR in 2005, which represents 39 % of the market share of Antitumor medications (cytostatics) (ATC = L01) group or 1.4 % of the market share for all of the drugs. The reason for this progressive increase is attributed to the increased use of mainly three drugs: imatinib mesylate trastuzumab, and rituximab. Conclusions: The discrepancies in admission and access to newer oncology drugs between Slovenia and other member states of EU are becoming smaller. The market of oncology drugs is increasing significantly faster compared to the whole drug market, mainly due to the new targeted drugs.

Health care system and nursing in Slovenia

INTRODUCTION Slovenia faces dilemmas and uncertainty in the development of health care but these do not differ from those encountered in most European countries. They include how to preserve health and social security in the light of a situation that will be marked by the problems of an ageing population, a related increase in chronic degenerative diseases, and growing needs and requirements for health care services. The Slovenian health care system remains relatively centralized and the selfgoverning communities still have limited responsibility. Privatization of health care delivery is taking place gradually in health centres and homes for elderly people. Very few private, for profit hospitals exist in Slovenia, with no more than 50 beds in total (Albrecht et al. 2002 a, b). The nurse education system is now adapting to the EU systems, and education has to be adjusted to the European Credit Transfer System agreed by the Bologna Declaration (European Commission 1998).

PREVENTIVE MEASURES FOR THE IMPROVEMENT OF THE SAFETY OF BLOOD TRANSFUSION AND VIRTUAL TRANSFUSION LABORATORY

Background. Even though blood transfusion is a relatively safe form of therapy, because of the eventual administrative errors in the transfusion chain between the blood donor and the recipient of blood, transfusion errors still occur. Therefore, it is imperative to ensure an utmost extent of safety and reliability of all transfusion related procedures. The safety of blood transfusion can be improved by preventive actions, i.e. implementation of the total quality management concept, haemovigilance and virtual transfusion laboratory. In the resulting system, the information web, robotics, computer sciences and communication technologies ensure safe and reliable identification of the patients, blood donors, corresponding test samples and blood products. Apart form this; the modern technologies enable the automation of laboratory testing, the integrity of laboratory results and enable an optimal use of blood. Conclusions. For an improved transfusion safety in Slovenia, adoption of corresponding prevention as well as haemovigilance is necessary. Identification errors can be prevented by implementation of the wristbands systems with the code bars for the tagging of the patient and his biological samples, whereas the administrative errors in the blood bank and transfusion laboratory can be prevented by implementation of information systems and automation. We assume that the virtual transfusion laboratory will become an integral part of the new Slovenian transfusion web and will speed up, unify and simplify today’s methods of ordering and administering blood products. To the attending physician, it will enable the choice of optimal transfusion therapy schedule and at the same time, it will enable the supervision of individual orders, deviations and indications, all of which is needed in order to analyse and improve the quality and the costs of the treatment. These services represent the first obligatory step for the modernisation of the transfusion medicine and accordingly, of the Slovenian health system in sense of the total quality assurance.

The profiles of importance of service quality components in health spas

Services are a primary force for economic growth in a modern society. At the same time the concept of quality is in the midst of managerial attention in every successful organization. Yet, extensive work in the field of empirical research involving the measurement of this important marketing variable and subsequently in the marketing management of quality in numerous service organizations all over the world has started only at the end of the eighties. As a result the author undertook an empirical study to identify the salient components of service quality and the nature of impact of several factors on the guests estimation of service quality in two successful Slovenian health spas. As the basis for the investigation this study utilizes the conceptual model of service quality as proposed by Parasuraman, Zeithaml, and Berry (1985).

Measurement of the Services Quality from the Customers Perspective

AbstractAbstract ‐ Services are becoming more and more a primary force for economic growth, in modern society. National economies that want to cope with changes are in the midst of a quality revolution. Yet, little has been done in the marketing management of the quality of services. Hence the article reveals some problems in this area and focuses on the measurement of the quality of services from the customers perspective. The systemic approach to the measurement is introduced as well as some findings of the research of the quality of the Slovenian health spas‐ services.