Among others, the healthcare system in Serbia was one of the sectors hugely impacted by the decades of reforms that began after the breakdown of former Yugoslavia, followed by hyper-inflation, wars and NATO bombing (Kunitz, 2004). Similar to other parts of former Yugoslavia, Serbia also implemented a mandatory healthcare system financed through health insurance contributions with the aim of providing comprehensive healthcare benefit for both inpatient and outpatient across the Serbian population. The healthcare insurance contributions were based on the 12.3% payroll taxes (McCathy, 2007).
However, with increasing political problems that influenced the healthcare system as well along with other economic performance measures, the method of Serbian healthcare system financing was challenged, especially with reference to the dichotomy between inpatient care and outpatient care. As a result, considerable healthcare deterioration happened that widened the gap between the EU population and the Serbian population. Furthermore, the onus of bridging the gap between healthcare revenues and healthcare expenditure fell upon the unsuspecting and vulnerable population. This shortage or gap between revenues and expenditures also resulted in salary cuts for medical workers, lack of appropriate availability of medical facilities and poor investment in medical infrastructure (Hjelm et al, 1999). There were huge deficits in the Insurance Fund. Healthcare accessibility, the basic right of every human, crumbled under corruption, bribery and lack of medical facilities (Mosseveld, 2003).
All these conditions led the Serbian government to reassess its healthcare funds and mark it as a national priority. As a result, the Institute of Public Health (IPH), the Health Insurance Fund (HIF) and the Ministry of Health (MoH) articulated a comprehensive healthcare plan in 2002. With the intention of reducing healthcare expenses, capitalizing on available medical resources and decrease the frequency of preventable diseases, the Serbian healthcare ministry aimed excellence in the primary healthcare service and focussed their attention on curative measures versus preventive measures (Miller, 2006). Changes in the financing segment were made so that it didn’t follow the crumbling existing methods. Along with financial reconfiguration, emphasis was laid upon developing healthcare packages and timely responding to patients’ needs. For primary healthcare, the Capitation model was chosen and for secondary healthcare, Diagnostic Related Groups (DRG) model was chosen for payments.
However, there was one major problem: lack of comparative data. For implementation of revised healthcare reforms, the health ministry needed reliable data that would highlight the financial prospects or sources utilised for healthcare and their method of use. To fulfill this requirement, the Serbian government sought help of the National Health Accounts (NHA) because the NHA would allow...