Assessment of the Effects of Cost-Sharing in Yugoslavia

In this study the existing forms and amounts of cost-sharing in the Republic of Serbia (Yugoslavia) are analyzed. The level of cost-sharing is ranked according to the number and type of services involved and the relative importance with which they are viewed within the overall health-care policy of...

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Bibliographic Details
Published in:Medical care 1988-02, Vol.26 (2), p.148-158
Main Authors: Simić, Snežana, Doknić-Stefanović, Danica, Marinković, Jelena, Živković, Mirjana
Format: Article
Language:English
Subjects:
Copayments
Correlations
Cost Allocation
Data Collection
Deductibles and Coinsurance
Financing, Personal
Health Expenditures
Health insurance
Health Resources - supply & distribution
Health Services - utilization
Health status
Hospital admissions
Humans
Medications
Mortality
Physicians
Population aging
Primary health care
Regression Analysis
Rural Population
Yugoslavia
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Summary:In this study the existing forms and amounts of cost-sharing in the Republic of Serbia (Yugoslavia) are analyzed. The level of cost-sharing is ranked according to the number and type of services involved and the relative importance with which they are viewed within the overall health-care policy of Yugoslavia. The "self-managing community of interest of health care," administratively coincident with the district, is taken as the unit of observation. Until recently, these bodies independently decided whether to introduce cost-sharing as well as the rate of cost-sharing. Therefore, the implementation of this health-policy measure differed among the districts generating inequality within health-care system. The results of simple and multiple correlation indicate that poorer districts with fewer health resources and lower levels of consumption introduced cost-sharing for more services, attempting to provide additional resources for financing of the health-care system. The multiple linear-regression model shows that population/physician ratio and the use of primary care physicians' services are the significant indicators of health-care expenditures in this territory. Considering the current economic situation in Yugoslavia and the level of development of the health-care system, the results of this cross-sectional study imply that cost-containment in health care can be achieved in a more equitable and effective manner by controlling supply of health services than by limiting demands.
ISSN:0025-7079
1537-1948
DOI:10.1097/00005650-198802000-00006