Delivering Health Services Efficiently for Serbian’s : Synthesis Report

World Bank

World Bank, Washington, DC

关键词: HEALTH SERVICE DELIVERY;    HEALTH SYSTEM MANAGEMENT;    HEALTH CARE EFFICIENCY;    HEALTH FINANCE;   

RP-ID  :  145495

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This review aims to provideevidence-based policy options to improve the performance ofthe Serbian health care system. The current rise ofnoncommunicable diseases (NCDs) and rapid aging in Serbiawill put significant budgetary pressures on the health caresystem and, in the absence of structural reforms, will leadto increasing costs. According to the latest estimates,about 17 percent of the population in Serbia is over 65years old, compared with 11 percent two decades ago. Thisproportion is expected to reach 25 percent in 2050. Meetingthese rising demands in a limited fiscal space and arelatively costly public delivery system requires thegovernment to enhance efficiency in public spending andservice provision while ensuring access to quality healthcare. Overall, achievements in the health sector have beenmixed. Serbia has achieved significant health gains in termsof life expectancy and basic health indicators, but theseare still far below the European Union (EU) average, andmarked differences are apparent across the country’sdistricts and population groups, such as the Roma. Thishealth care system review also carried out a productivityanalysis of health care providers in the public sector. Thefindings show that both outpatient and inpatient healthfacilities vary greatly in terms of productivity and thatroom exists for efficiency gains. There were 139 publicprimary health care (PHC) facilities included in theanalysis. The gaps in cost per visit and visits per staffbetween the least productive and the most productive groupsof facilities were wide, indicating an opportunity foroptimization and cost savings. There is also large variationin productivity within and across types of hospitals. Moreproductive hospitals also have better quality indicators andother outcomes. On average, the most productive hospitalshad a higher occupancy rate, less staff per bed, and ashorter length of stay. The productive group also had loweracute myocardial infarction and stroke readmission rates andlower C-section rates.