State and market

The debate about the relationship between state and market, about their relative importance, does not cease to be topical, and there is no end of it in sight. The market (invisible hand) does need, more or less, the help of the state (visible) hand. Liberal sympathizers of the market prefer a “small” state whose ambitions include only providing an adaptable legal framework in which and by which the market functions, and (re) allocation of resources, because of the inherent defects of the market. Proponents of welfare economics will wish for progressive taxation and redistribution of income. Keynes’s mission to save capitalism meant an increase in the importance of the state and appearance of a new, stabilizing role of the state. Excessive unemployment is to be prevented by fine-tuning. Unfortunately, Keynes’s critics from the public choice camp will say that the state (government) is not perfect, and, as a rule, falls into the trap of asymmetry. Only and solely in theory will it apply that a perfect state means perfect functioning of an imperfect market

State and market

The debate about the relationship between state and market, about their relative importance, does not cease to be topical, and there is no end of it in sight. The market (invisible hand) does need, more or less, the help of the state (visible) hand. Liberal sympathizers of the market prefer a “small” state whose ambitions include only providing an adaptable legal framework in which and by which the market functions, and (re) allocation of resources, because of the inherent defects of the market. Proponents of welfare economics will wish for progressive taxation and redistribution of income. Keynes’s mission to save capitalism meant an increase in the importance of the state and appearance of a new, stabilizing role of the state. Excessive unemployment is to be prevented by fine-tuning. Unfortunately, Keynes’s critics from the public choice camp will say that the state (government) is not perfect, and, as a rule, falls into the trap of asymmetry. Only and solely in theory will it apply that a perfect state means perfect functioning of an imperfect market

Pharmacoeconomical Impacts of Crohn’s Disease

Provide an overviewof Crohn’s disease and its cost assessment options, establish the need for implementing Croatian national Crohn’s Disease Registry to precisely quantify the costs and the outcomes, and establish model to evaluate values of treatment options for Crohn’s disease

The Prevalence and the Risk Factors of the Cervical Colonization by the Genital Mycoplasmas among Pregnant Women from Eastern Croatia

The aim of this study was to determine the prevalence of the genital mycoplasmas cervical colonization among the pregnant women from the Eastern Croatia and to evaluate its correlation with the demographic and the behavioural risk factors. Study was conducted from March 2010 to April 2011 at the Microbiology Department of the Institute of Public Health for the Osijek-Baranja County. The study included 456 pregnant women in the first and the second trimester of pregnancy. Demographic data and data on their possible risk behaviour during the lifetime were collected with the usage of an anonymous questionnaire consisting of the 16 questions. The Mycoplasma Duo kit test was used to diagnose the mycoplasma infections. Due to the fact that the results were generally similar for the women with U. urealyticum or M. hominis and in order to dichotomize the analyses, 164 (36%) participants with U. urealyticum, M. hominis or both were considered positive, whereas 292 (64%) participants without U. urealyticum or M. hominis were considered negative. A higher genital mycoplasmas prevalence was statistically significantly associated with the younger group of the pregnant women (16–29 y), 5 or more sexual partners during lifetime and the age on the first intercourse £16. The study has showed that both the demographic and the behavioural risk factors were associated with the higher genital mycoplasmas colonization in the observed population

Neki pokazatelji kretanja zdravstvene zaštite u Hrvatskoj od 2000. do 2007. godine

Na temelju godišnjih publikacija HZZO u ovom su radu uspoređeni indeksi broja usluga u zdravstvenim ustanovama, odnosno izdanih recepata u ljekarnama te izdaci i prosječne cijene u primarnoj zdravstvenoj zaštiti (PZZ), ljekarnama, specijalističko-konzilijarnoj zdravstvenoj zaštiti (PKZZ) i bolnicama. Prosječne cijene u PZZ i bolnicama ne samo da apsolutno, nego i relativno padaju. Pad bi bio i veći da je u proračun uključena i godišnja inflacija. Prosječna cijena za lijekove, a nešto manje i prosječna cijena u SKZZ nadilaze sve druge prosječne cijene u zdravstvu. U zadnje su dvije godine očito napravljene neke ispravke u zdravstvenom sustavu koje su dovele do približavanja prosječnih cijena.Zdravstveni sustav je veliki i složeni sustav u svakoj državi. Svaka država oblikuje zdravstveni sustav prema svojim potrebama i mogućnostima. Proces oblikovanja je trajan, a ovisi ponajprije o financijskoj moći države, ustroju zdravstvenog sustava i kadrovima. Republika Hrvatska je tijekom i nakon Domovinskog rata započela s velikim promjenama ili reformama zdravstvenog sustava koje neprekidno traju sve do današnjega dana. Drugačije i ne može biti jer je zdravstveni sustav kao živo tkivo koje nije i ne može danas biti isto kao što je bilo jučer. Najvažniju ulogu u oblikovanju sustava imaju političke odluke koje stvaraju okvir u kojemu je moguće provoditi zdravstvenu zaštitu. S druge strane, zdravstveni sustav povratno utječe na postavljeni okvir tako da ga neprestano želi promijeniti pritisnut novim spoznajama koje nastaju u sustavu. Teško je predvidjeti kada i gdje će se pronaći ravnoteža koja može osigurati ravnomjerno razvijanje svih elemenata zdravstvenog sustava, odnosno nipošto ne dozvoliti da jedan dio zdravstva napreduje na štetu drugoga, jer tada to više nije kvalitetan sustav.Pokazatelje koji ukazuju na uspješnost promjena u zdravstvu je najlakše crpiti iz službenih izvješća Hrvatskog zavoda za zdravstveno osiguranje (HZZO) koja je jedina publikacija javno dostupna iz koje je moguće iščitati podatke koji se odnose na cijelu državu, ali ne i podatke vezane za županije, odnosno pojedinačne zdravstvene ustanove, nažalost. Na temelju godišnjih publikacija HZZO u ovom su radu uspoređeni indeksi broja usluga u zdravstvenim ustanovama, odnosno izdanih recepata u ljekarnama te izdaci i prosječne cijene u primarnoj zdravstvenoj zaštiti (PZZ), ljekarnama, specijalističko-konzilijarnoj zdravstvenoj zaštiti (PKZZ) i bolnicama. Nažalost, HZZO je u posljednje dvije godine djelomično promijenio prikaz pojedinih pokazatelja. Kao temeljna godina uzeta je 2000. godina.Broj usluga je jedan od općih pokazatelja dinamike zdravstvene zaštite koje pokazuju u kojem dijelu zdravstvenog sustava dolazi do porasta, odnosno pada broja usluga i koliko su one značajne u odnosu na druge parametre (slika 1). Indeks usluga u PZZ raste prosječno 15% sve do 2006. godine, a pada 2007. godine. Lijekovi na recept rastu od 2002. godine prosječno 12%. Nagli je porast u 2007. godini. Slično ovome događa se i u PKZZ s tim da je godišnji porast prosječno 22% što je među promatranim parametrima najveći porast. Indeks usluga u bolnici gotovo da se uopće ne mijenja. Ako se usporede indeksi usluga u PZZ i PKZZ usluge u PKZZ rastu tako brzo da se postavlja pitanje rastu li zbog PZZ koja nije u mogućnosti odgovoriti potrebama zdravstva u liječenju i dijagnostici ili je posrijedi tromost i nezainteresiranost liječnika PZZ obzirom na sustav financiranja da ulažu u kvalitetu svojih usluga

INDICATORS OF FINANCIAL MANAGEMENT OF THE CROATIAN HEALTH INSURANCE FUND FROM 2000 TO 2014

The goal of this research is to establish a connection and a mutual influence between the expenditure of funds of the Croatian Health Insurance Fund in Croatia from 2000 to 2014, expenditure per levels of healthcare, and the trend of services provided. This method uses the determination coefficient. Despite the increased spending of the CHIF in Croatia by as much as 80.6% (from 13.4 billion in 2001 to 24.2 billion in 2014), the primary healthcare shares, as well as hospital and polyclinic healthcare shares, have been reduced in the same time period. Contrary to that, expenses for medicaments are rising, as well as the expenses for the ‘other expenses’ group. Primary healthcare (PH, Croatian: Primarna zdravstvena zaštita) has significantly reduced price per service. Hospital healthcare (HH, Croatian: Bolnička zdravstvena zaštita) has the same number of hospitalizations, but their length has been significantly reduced. In processing the public publication data of the CHIF, the structure of data portrayed has been changing every few years so some data is impossible to track continuously. It is also impossible to understand the reason for such an attitude. PH, HH, and polyclinic advisory healthcare (PAH, Croatian: Poliklinička konzilijarna zdravstvena zaštita) are levels with the strongest and most decisive influence on the quality of the healthcare system on the one hand, and they are showing a strong negative trend in expenses with regard to medicaments and other expenses on the other hand

State and market

The debate about the relationship between state and market, about their relative importance, does not cease to be topical, and there is no end of it in sight. The market (invisible hand) does need, more or less, the help of the state (visible) hand. Liberal sympathizers of the market prefer a “small” state whose ambitions include only providing an adaptable legal framework in which and by which the market functions, and (re) allocation of resources, because of the inherent defects of the market. Proponents of welfare economics will wish for progressive taxation and redistribution of income. Keynes’s mission to save capitalism meant an increase in the importance of the state and appearance of a new, stabilizing role of the state. Excessive unemployment is to be prevented by fine-tuning. Unfortunately, Keynes’s critics from the public choice camp will say that the state (government) is not perfect, and, as a rule, falls into the trap of asymmetry. Only and solely in theory will it apply that a perfect state means perfect functioning of an imperfect market

Cervical Cancer in Osijek-Baranja County – Possibilities for Prevention

In Osijek-Baranja County, there was a rise in the number of non-invasive and fall of invasive cervical cancer in the period 2000–2008, but cervical cancer still represents an important public health problem in Osijek-Baranja County. Cervical cancer in 2008 was the ninth female cancer site and represents 3.5% of all malignant diseases in women. In the same year it was also at the ninth place of all cancer deaths in women with a share of 3.3%. The large number of women cervical cancer was detected at an advanced stage of the disease so that there is an pincrease in mortality from cervical cancer. Although the incidence of cervical cancer is lower in relation to Croatia and other countries in the region, the mortality rate is still higher than in the countries of Western Europe. In order to reduce the incidence and mortality of cervical cancer primary task of the public health system is the introduction of secondary prevention through properly organized screening program. The program should be tailored to the financial and human resources and local specificities, with the agreement on a strategy that will give the best results

Prevalence and Risk Factors for Herpes Simplex Virus Type 2 Infections in East Croatia

The aim of the study was to establish the seroprevalence of herpes simplex virus type 2 (HSV-2) among sexually active adults from East Croatia and to evaluate its correlates with demographic and behavioural risk factors. This cross-sectional study was conducted from the 1st June until the 30th September 2005 at the Department of Transfusion Medicine, Osijek University Hospital Center. The study included 423 blood donors composed of 366 (86.5%) men and 57 (13.5%) women. Demographic data and data on the risky sexual behaviour during the lifetime were collected with usage of an anonymous questionnaire consisting of 15 questions. Western blot testing revealed that 3.3% (14/423) subjects were positive for the presence of IgG antibodies to herpes simplex virus 2, i.e. 10 (2.7%) men and 4 (7.0%) women. A higher HSV-2 seroprevalence was associated with female sex, older age, marital status (with single subjects been under the greater risk), irregular condom use on sexual intercourses with new partners and with higher number (five or more) of sexual partners during lifetime. Among determined risk factors in the study population, only the connection between the HSV-2 positivity and the older age was statistically significant. The study has showed that the demographic rather than the behavioural risk factors are associated with higher prevalence of HSV-2 antibodies in the observed population

Effect of Aminglycoside Administration on the Occurrence and Multiplication of Resistant Bacteria

In the prospective study the susceptibility of 41 Escherichia coli strains and 55 Pseudomonas aeruginosa strains to gentamicin, netilmicin and amikacin was tested at a 2-year interval (period I April 1998 to March 1999, and period II April to July 2001). Genotyping was performed by pulsed-field gel electrophoresis, and a clone based on 80% or 90% similarity was determined for each of the study bacteria. In 24 (32.0%) clones, strains showed no variation over 2-year interval, supporting the hypothesis on a priori susceptible strains. Transformation from susceptibility in period I to resistance in period II was demonstrated in 5 (6.7%) clones, a pattern consistent with the concept of bacterial development of resistance under the influence of antibiotics. However, there were 10 (13.3%) clones whose strains exhibited an inverse pattern. Accordingly, two-way transformation of susceptibility took place during the study period. The utilization of the study aminoglycosides had no major impact on the variation of microbial susceptibility. Changes in microbial susceptibility were found to follow some regular patterns, which were not influenced by the study aminoglycosides. Two phenomena were observed: (i) there were stable clones that did not develop resistance in spite of selective antibiotic challenge; and (ii) changes of susceptibility in isolated bacteria from both inpatient and outpatient strains of the same clone were two-way and reversible