Реформи во здравството - приватизација на примарната здравствена заштита и други модели за подобрување на ефективноста и ефикасноста во користењето на здравствените ресурси

Неда Милевска-Костова


Since the independence in 1991, Republic of Macedonia, in parallel with thetransition from agreed to market economy and political pluralism, has been goingthrough a phase of elaborate reforms in the healthcare system. In 2005,the reform of the primary healthcare has been undertaken intensively, throughits transformation from the public into private sector, using the concession approachof public services provision by private healthcare providers. This processwhich has been completed in 2007, involved the Ministry of Health of the Republicof Macedonia, health Insurance Fund of the Republic of Macedonia andthrough HIF – the users of healthcare services, as well as the public healthcaresettings in primary healthcare. Almost three years later, some of the effects ofthis transformation can be evaluated, and can serve as good experience for theupcoming reforms of the other segments of the healthcare system – secondaryand tertiary healthcare.However, due to the specificity of the secondary and tertiary healthcare, thesetwo segments cannot be transformed using the exact same model, therefore,this paper reviews the possible models for reforming in the direction of improvementof the utilization of the healthcare resources. At the same time, besidesthe economics aspects, the principles of solidarity, equal access to healthcare,quality of care and patient safety are taken into consideration.

Key words: primary healthcare, health reforms, privatization, healthcare model.

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