FINANCING HEALTH CARE SYSTEM AND THE ROLE OF CAPITATION IN THE SERBIAN CONTEXT

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FINANCING HEALTH CARE SYSTEM AND THE ROLE OF
CAPITATION IN THE SERBIAN CONTEXT

• Dr Olivera M. CIRKOVIC
• Prof. dr Milica Prostran
• Dr Mladen Jecmenica
• Dr Gordana Markovic

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THE SERBIAN CONTEXT

• The Ministry of Health and the Health Insurance
  Fund would like to introduce a capitation-based
  resource allocation and reimbursement system
• Such a system would be applied to the primary
  health care system
• The Ministry and Health Insurance Fund are
  working with external support to identify and
  introduce the appropriate capitation model for
  PHC in Serbia

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• Capitation project aims to assist Serbia to
  develop its Primary Health Care further to meet
  the changing needs of the people
• One of the tools for better health services is
  the so called Capitation Payment System

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PHC FINANCING SCHEMATA - SERBIA
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HEALTH SYSTEM FINANCING OBJECTIVES

• Maximise population health status improvement
  (quantity and quality of life)
• Ensure equity of access for equal need
• Reduce health inequalities (link to Millennium
  Development Goals)
• Provide safe and high quality patient-centred
  services
• Ensure sustainability in terms of resources
  available (capital, revenue, manpower)
• Efficiency and effectiveness
• Promote solidarity amongst citizens
• Facilitate decentralisation/engagement of those
  spending money
• Ensure and develop human resources

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WHAT IS CAPITATION ?

• Capitation A fixed sum per person paid in
  advance of a coverage period (usually 1 year) to
  a health care entity (facility) in consideration
  of its providing, or arranging to provide,
  contracted health care services (package of PHC
  services) to an eligible person for the specified
  period.
• T.Bourden, M.Priven, K.Passwater An
  introduction to Capitation and Health Care
  Provider Excess Insurance

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• The project has tested the implementation of the
  new capitation system in 28 Primary Health Care
  Centers (PHCC) in Serbia
• The 28 PHCC are situated in 22 regions out of the
  25 regions Serbia
• Seven PHCC of the total of 16 PHCC in Belgrade
  are included
• One of them is PHCC Zemun

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PROBLEMS

• We started implementation 6 months later then
  others
• It was serious problem according to 191,000
  habitants that PHCC Zemun take care of

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RESULTS

• New management competencies of managers
• Changes of management skills (through education)
• Competencies in information technology and use of
  specific software (e.t. one third of the managers
  reported they have low competence or no
  competence at all in general IT skills)
• Capitation specific skills among managers, middle
  management and other staff
• In January 2009 119. 286 habitants were
  registered (62).

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CONCLUSION

• Capitation has future in Serbia if we keep
  formulae transparent, simple and flexible

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Thank you

• chirkovich_olja_at_yahoo.com