Abstract
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PROFESSOR STANKA SETNIKAR CANKAR
FACULTY OF ADMINISTRATION
UNIVERSITY OF LJUBLJANA
HEALTH CARE REFORM IN SLOVENIA AND IMPLEMENTATION OF CHANGES
Introduction
In this paper we present the organisation, operation and especially financing of the healthcare system in Slovenia. The described findings have motivated us to carry out a research project, the outline of which we present in this paper. The pilot study, presented in this paper as an outline, provides some of the answers to a number of questions posed in Slovenia at this time, both political and professional, that is, from both the providers and payers for healthcare services. We have attempted to find answers to questions of standards or content of individual healthcare services and the costs associated with them.
Topical Problems
In developed nations throughout the world healthcare systems are undergoing some level of transformation. The reasons behind this are similar all over – bureaucracy, uncontrollable increases in quantities and prices of services, unfavourable demographic development and poor management have all caused difficulties in financing healthcare systems Slovenia is no exception in this. There are still greater problems – certain hardened principles, especially that associated with social rights and the material capabilities of society – along with the above stated difficulties - make it very difficult to finance the desired healthcare system.
To this time Slovenia has managed to avoid a total collapse of its healthcare system, and is managing to hold onto its “quantity and quality”, though it is more difficult to confirm the preservation of accessibility and rights under compulsory healthcare insurance. This is of course connected to its financing. It is therefore not surprising that when each year’s budget is adopted and contracts signed between providers and the healthcare insurer, there are debates as to the necessity of change in the network of public healthcare institutions, private healthcare provision, method of financing and changes or decisions on non-existing standards of services and their financing, on contribution rates, saving programmes, etc. In reality, solutions are seen in savings, due to too little funds available and the aggravated financial situation of providers and insurers. In all wishes and attempts made, the content of service, their costs and particularly universal standards for performing them as well as financing on the basis of actual services performed, i.e. their costs, could not remain “untouchable”.
This is also the reason this paper deals with financing healthcare institutions, particularly hospitals as the greatest consumer of resources in the health service. An introduction to the healthcare system in Slovenia is followed by a more detailed description of the functioning of hospitals, together with problems associated with their funding.
It is a problem as to how long Slovenia can keep this position with its healthcare expenditure – 7 to 8% of GDP. Accessibility is worrying, there are only just sufficient resources from private means and nobody is satisfied with the institute’s financial problems and system of financing. All these are reasons for this paper and pilot study that intervenes into standards, service content and its costs – the economics of healthcare.
In conclusion, we present the pilot research project, motivated by findings in this paper.
We try to verify our thesis against collected and compared data obtained from selected hospitals. The subject of research is gynaecological-maternity services and their costs in each hospital. We have determined a time for collecting data (diagnostic procedures, interventions, material, staff, other costs) and method of selecting services for comparison. Analyses should follow shown differences and proposals for rationalisation or standardisation of service content.
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