The cost of health care in Serbia according to the international classification of diseases for the period from 2004 to 2009

Abstract

Introduction. As the part of research on costs in the health care system, there is a growing interest in the world for the estimating costs for the treatment of disease. This value represents the burden that a particular disease or group of diseases puts on the society. Until the year 2000, when the Organization for Economic Countries Development (OECD) established a System of Health Accounts (SHA), there was not even approximate methodological guide for calculating the cost of the disease. The aim of this study was to determine the costs of health care in the Republic of Serbia according to the major International Classification of Diseases (ICD-10) and to provide a comparative cost analysis for the treatment of diseases in the period from 2004 to 2009. Material and Methods. A retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia and financial information provided by the Health Insurance Fund in the period 2004-2009 was performed. Financial information and data on hospital services, outpatient, home health care, ancillary health care services, drug consumption and consumer goods in healthcare were analyzed using SHA methodology. Results. Results showed that during the observation period, the maximum cost of health care in Serbia by main classification of ICD-10 was achieved in 2009 and it was RSD 144,150,456,906.00 (€ 1,503,321,134; $ 2,160,253,219) and the minimal cost was achieved in 2004 - the amount being RSD 49,546,211,470.00 (€ 628,086,723; $ 855,203,134). Results showed that in 2004 the highest costs were allocated to circulatory diseases (18.98%), followed by neoplasm (11.12%), and lowest for congenital anomalies (0.64%). In 2009, the highest costs were allocated to circulatory diseases (18.87%), infectious and parasitic diseases (11.20%), diseases of digestive system (9.26%) nervous system diseases (9.20%), and neoplasm (8.88%), whereas the minimal funds were allocated for congenital anomalies (0.33%). Conclusion. Comparative analysis showed that the value of overall spending in healthcare increased three times in 2009 as compared to 2004.

Uvod. U okviru istraživanja troškova u sistemu zdravstvene zaštite poslednjih deset godina u svetu je sve veće interesovanje za izračunavanje troškova lečenja bolesnika. Ova vrednost je breme kojim određena bolest ili grupa oboljenja opterećuje društvo. Do 2000. godine, kada je Organizacija za ekonomski razvoj država (OECD) formirala Sistem zdravstvenih računa (SZR), nije postojalo okvirno metodološko uputstvo za izračunavanje cene lečenja bolesnika. Cilj ovog rada bio je da se utvrde troškovi zdravstvene zaštite u Srbiji prema Međunarodnoj klasifikaciji bolesti (MKB) od 2004. do 2009. godine. Materijal i metode rada. Urađena je retrospektivna i komparativna analiza zdravstvenih statističkih podataka iz baze Instituta za javno zdravlje Srbije i finansijskih podataka Republičkog zavoda za zdravstveno osiguranje za period 2004-2009. godine. Finansijski i podaci o uslugama bolničkog, ambulantnog i kućnog lečenja, pomoćnim uslugama zdravstvene zaštite, potrošnji lekova i potrošnih dobara u zdravstvu analizirani su primenom metodologije SZR. Rezultati. Tokom posmatranog perioda najveći trošak za zdravstvenu zaštitu ostvaren je 2009. godine, a iznosio je 144.150.456.906,00 dinara (1.503.321.134 evra; 2.160.253.219 američkih dolara), dok je najmanji ostvaren 2004. godine, a bio je 49.546.211.470,00 dinara (628.086.723 evra; 855.203.134 američkih dolara). Te godine najveći deo troškova bio je izdvojen za lečenje od kardiovaskularnih bolesti (18,98%) i tumora (11,12%), a najmanji deo za lečenje osoba s urođenim anomalijama (0,64%). U 2009. godini najveći deo sredstava utrošen je za lečenje od kardiovaskularnih oboljenja (18,87%), infektivnih i parazitskih bolesti (11,20%), oboljenja digestivnog sistema (9,26%), bolesti nervnog sistema (9,20%) i tumora (8,88%), dok je najmanje novčanih sredstava izdvojeno za lečenje osoba s urođenim poremećajima (0,33%). Zaključak. Komparativna analiza je pokazala da su se troškovi zdravstvene zaštite stanovnika Srbije od 2004. do 2009. godine povećali čak tri puta.