Zaposleni u zdravstvu u transformaciji zdravstvenog menadžmenta

Introduction: The importance of studying management in one of the most sensitive and complex areas of human endeavor that is healthcare is of great significance for providing high quality and efficient easily-accessible healthcare in the future. Studying the challenges that need to be overcome towards achieving this goal is of great importance not only from the viewpoint of scientific management theory but primarily to help bring about strategically important decisions that are crucial for the continued evolution and reformation of the healthcare system, in which the employees have a new, much more complex role. The objective: was to more thoroughly study, describe and understand the role the employees have in the transformation of health care management. Material and method: During this research the material used was foreign and local literature, processed using the Analytical method as well as the Observation and Comparative methods. Conclusion: In the transformation of the health care management a very important role is played by the health care employees. Without the transformation of the current practice and significant changes in both the structure and work ethic of all the employees in health care services (nurses and people in management alike) there will be no improvement in the health care system overall.Uvod: Značaj proučavanja menadžmenta u jednom od najkompleksnijih i najosetljivijih ljudskih delatnosti kao što je zdravstvo od izuzetne je važnosti za budućnost pružanja kvalitetne i efikasne, svakom dostupne zdravstvene zaštite. Važnost proučavanja ove problematike bitna je ne samo sa gledišta naučne teorije o menadžmentu, već, pre svega, radi donošenja strateški važnih odluka za dalje funkcionisanje i razvoj novog, reformisanog zdravstvenog sistema u kome zaposleni u zdravstvu imaju novu, mnogo kompleksniju ulogu. Cilj rada je bio da se jasnije prouči, opiše i sagleda uloga zaposlenih u zdravstvu u transformaciji zdravstvenog menadžmenta. Materijal i metod: Prilikom istraživanja ove teme materijal za rad je bila strana i domaća literatura, obrađena korišćenjem Analitičkih metoda, a koristio se i Metod posmatranja , kao i Komparativne metode. Zaključak: Uloga zaposlenih u zdravstvu u transformaciji zdravstvenog menadžmenta je izuzetno kompleksna i važna. Bez temeljne transformacije dosadašnje prakse rukovođenja u zdravstvu i bez značajnih promena, kako u strukturi, tako i u radu svih zaposlenih u zdravstvenim službama, bilo da se radi o medicinskom ili ne medicinskom osoblju, neće biti ni poboljšanja u zdravstvenom sistemu u celini

Uloga i osobine menadžera u strateškoj transformaciji zdravstvenog menadžmenta

Introduction: Global markets and competition, fast changes, the explosion of information technology, integration processes in international relations are some of the initial factors for changes in health care organizations and their management. Management represents an evolving new generic function of all organizations of social significance across the world. Managers in the health sector have exceptionally complex roles that require new skills and methods. The objective of this study is to analyze in grater detail, explain and describe the role and necessary skills of a health care manager in the strategic transformation of health care management. The modern health care manager can get the best results by strengthening human resources and meeting employees' personal needs in accordance with the global and specific goals of the health care institution. The manager is at the same time a mentor and a facilitator, putting to best use the forementioned transformation strategies whilst expending the resources carefully, strengthening the collective efforts, involving employees in the decision-making process and motivating teamwork and collective problem-solving.Uvod: Globalna tržišta i kompeticija, brze promene, eksplozija informatičke tehnologije, integracioni procesi u međudržavnim odnosima samo su neki od faktora koji su inicirali nužnost promena i u zdravstvenim organizacijama i njihovom menadžmentu. Menadžment postaje nova generička funkcija svih organizacija od društvenog značaja širom sveta, koji ima izuzetno tešku ulogu da usaglasi kompleksne probleme kojima obiluje specifična delatnost zdravstvenih službi.U svetlu tih promena menja se i uloga kao i osobine i veštine menadžera u zdravstvu. Cilj ovog rada je da se jasnije opiše i sagleda uloga, potrebne veštine i metodi kojima se služe menadžeri u zdravstvu u strateškoj transformaciji zdravstvenog menadžmenta. Moderan zdravstveni menadžer postiže najbolje rezultate kroz ojačavanje ljudskih resursa i zadovoljenje individualnih potreba zaposlenih, a u skladu sa opštim i specifičnim ciljevima zdravstvene organizacije. Menadžer je u isto vreme i mentor i facilitator jer koristi maksimalno navedene strategije promena, a resurse oprezno uz učvršćivanje kolektivnih napora, uključivanje zaposlenih u odlučivanje, podsticanje timskog rada i grupnog rešavanja problema

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

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

Komparativna analiza zdravstvenih ustanova, kadra i usluga privatnog i državnog sektora u zdravstvenom sistemu Srbije u 2009. godini

Introduction. Collecting data about the structure and function of private health care sector in Serbia and its inclusion in joint health care system is one of the most important issues for making decisions in health care and getting more accurate picture about the possibilities of health care system in Serbia. The aim of this analysis was to compare health institutions, personnel, visits, number of hospital days and morbidity by ICD-10 classification of diseases in public and private health sector in South Backa, Nisava, Toplica and Belgrade district in 2009. Material and Methods. A retrospective comparative analysis was performed using data about private providers of health services obtained from the Institute of Public Health Novi Sad, the Institute of Public Health Nis and the City Institute of Public Health Belgrade. Data about personnel and morbidity in public health sector in Serbia for 2009 was obtained from the Center for Information Technology of the Institute for Public Health of Serbia. Data about public health facilities in South Backa, Nisava, Toplica and Belgrade district in 2009 was obtained from Serbian Chamber of medical institutions. Results. The results showed that health care was provided in Belgrade district in 2009 by total of 1,051 employees in private sector and 31,404 in public sector. We found that public sector had a far wider range of health facilities than private sector, which was mainly due to the number of clinics. In South Backa district private sector had 323 practices, the district of Belgrade 655 and Nisava and Toplica district 173. Seventeen times more visits to households (4,650,423 vs. 267,356) and 111 times greater number of hospital days was provided in public health sector as compared to private health sector (781,083 vs. 7,023) in South Backa district. Conclusion. The conclusion of this analysis was that public health sector has remained the foundation of health care system in Serbia. Private health sector is expanding, but its structure and scope of services is still undervalued as compared to public sector.Uvod. Prikupljanje podataka o strukturi i radu privatnog zdravstvenog sektora u Srbiji i njegovo uključivanje u planove funkcionisanja zdravstvene zaštite jedno je od važnih pitanja za donošenje odluka u zdravstvu, kako bi se dobila što preciznija slika o mogućnostima državnog i privatnog zdravstvenog sistema u Srbiji. Cilj ove komparativne analize bio je poređenje zdravstvenih ustanova, kadra, poseta lekaru, broja bolesničkih dana i morbiditeta prema Desetoj reviziji Međunarodne klasifikacije bolesti (MKB-10) u državnom i privatnom sektoru, u Južnobačkom, Nišavskom, Topličkom i Beogradskom okrugu u 2009. godini. Materijal i metode rada. Urađena je retrospektivna analitička komparativna studija na osnovu podataka o privatnim pružaocima zdravstvenih usluga dobijenim od Instituta za javno zdravlje u Novom Sadu, Instituta za javno zdravlje u Nišu i Gradskog zavoda za javno zdravlje u Beogradu. Podaci o kadru i morbiditetu u državnom sektoru zdravstvenog sistema Srbije za 2009. godinu preuzeti su od Centra za informatiku Instituta za javno zdravlje Srbije. Mreža državnih zdravstvenih ustanova u Južnobačkom, Nišavskom, Topličkom i Beogradskom okrugu u 2009. godini preuzeta je od Komore zdravstvenih ustanova Srbije. Rezultati. Analiza je pokazala da je zdravstvenu zaštitu u privatnom sektoru u 2009. godini u Beogradskom okrugu pružao ukupno 1.051 zaposlen medicinski radnik, dok su zdravstvenu zaštitu u državnom sektoru pružala 31.404 zaposlena lica. Utvrđeno je da državni zdravstveni sektor ima daleko širi spektar zdravstvenih ustanova od privatnog, koji se uglavnom temelji na velikom broju ordinacija. U Južnobačkom okrugu privatni sektor ima 323 ordinacije, u Beogradskom 655, a u Nišavskom i Topličkom 173. U državnom zdravstvenom sektoru u Južnobačkom okrugu ostvaruje se 17 puta veći broj poseta lekaru u odnosu na privatni (4.650.423 prema 267.356) i 111 puta veći broj bolesničkih dana (781.083 prema 7.023). Zaključak. Državni zdravstveni sektor je i dalje temelj zdravstvenog sistema Srbije. Privatni zdravstveni sektor se sve više razvija, ali njegova struktura i obim pruženih usluga i dalje su značajno manji u poređenju sa državnim

Troškovi u primarnoj zdravstvenoj zaštiti u Republici Srbiji u periodu 2006-2008. godine

Introduction. Primary health care in the Republic of Serbia is predominantly funded by the Republic Health Insurance Fund (RHIF). From the total income of health centers and institutes at the primary level, with no pharmacy and pharmacies (Kosovo excluded), 84% in 2008 was paid by RHIF. Frequency of participation ranged from 63-95% and it was stable in all observed years. The aim of this study was to determine the expenditures for primary health care for each insured person in statistically defined districts in the Republic of Serbia, with an emphasis on prevention participation. Material and Methods. Retrospective and comparative analysis of health statistics from the database of the Institute of Public Health of Serbia (IPHS) and financial data from the RHIF for the period 2006-2008 was done. Results. Observed by the districts in 2008, in Vojvodina, the lowest expenditure for primary health care had North Backa District (5,207 RSD) and greatest was in West Backa District (6,632 RSD) per capita. In the central Serbia territorial difference was much greater, ranging from 3,574 RSD in the District Morava to 6,701 RSD per capita in the District Toplica and Nisava. Expenditures for direct health care of RHIF per capita in the reporting period continuously have grown. Conclusion. The results showed that the largest cost for primary care for the insured person in the districts of Serbia was registered in the Nisava and Toplica (6,701 RSD) and lowest in the district of Morava (3,574 RSD) per capita.Uvod. Primarna zdravstvena zaštita u Republici Srbiji se dominantno finansira od Republičkog zavoda za zdravstveno osiguranje (RZZO). U ukupnim prihodima domova zdravlja i zavoda na primarnom nivou, bez apoteka i apotekarskih ustanova (isključujući Kosovo i Metohiju), RZZO je u 2008. godini učestvovao s prosečno 84%. Interval učešća je bio 63-95% i gotovo je istovetan u svim posmatranim godinama. Cilj rada je bio da se utvrde rashodi za primarnu zdravstvenu zaštitu po svakom osiguranom licu u statistički definisanim okruzima u Republici Srbiji, s osvrtom na preventivu. Materijal i metode rada. Izvršena je retrospektivna i komparativna analiza zdravstvenih statističkih podataka iz baze Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' i finansijskih podataka iz RZZO u periodu 2006-2008. godine. Rezultati. Posmatrano po okruzima u 2008. godini, u Vojvodini je najniže rashode za primarnu zdravstvenu zaštitu po stanovniku imao Severnobački okrug (5.207 dinara), a najviše Zapadnobački (6.632 dinara). U centralnoj Srbiji teritorijalne disperzije su znatno veće: od 3.574 dinara po stanovniku u Moravičkom okrugu do 6.701 dinar po stanovniku u Nišavskom i Topličkom okrugu. Rashodi za neposrednu zdravstvenu zaštitu RZZO po stanovniku su se u posmatranom periodu kontinuirano povećavali. Zaključak. Rezultati istraživanja su pokazali da je za primarnu zdravstvenu zaštitu po osiguranom licu u Republici Srbiji najviše potrošeno u Nišavskom i Topličkom okrugu, a najmanje u Moravičkom

Ispitivanje finansijskih tokova u zdravstvenom sistemu Republike Srbije u periodu od 2003. do 2006. godine

Background/Aim. The main goal of every health policy is not merely the establishment of the health system sustainability, but the accessibility of health services to the whole population, as well. This objective is shared in European Union countries, and the consequence is the implementation of National Health Accounts (NHA). NHA, as a tool for evidence-based management, provides data regarding financial flow in health at national level and alows international comparability. The aim of this study was to determine Serbian overall health spending patterns by National Health Accounts, and to determine health care indices to provide policy makers with internationally comparable health indicators. Methods. A retrospective analysis of healthcare expenditures was obtained from the published final financial reports of relevant state institutions during a period of 2003 to 2006. The various sources of data on healthcare expenditures were connected according to instructions by the OECD 'A System of Health Accounts (SHA)' Version 1.0. Results. The obtained results showed: health expenditures in Serbia made up 8.6%, 8.3%, 8.7% and 9 % of the GDP in 2003, 2004, 2005 and 2006, respectively; the Health Insurance Fund was a predominant financing source of the public sector with 93% in 2006; the largest part of the total health expenditures went towards hospitals and for health services; the expenditure per capita in 2006 was 365 US$; Serbian population finances the state institutions 'out of pocket' with 21.28% of their sources, which was 7.3% of the total healthcare expenditures, and the private institutions with 78.72% of their financial sources, which is 27% of the total healthcare expenditures. In 2006 Serbia allocated financial resources out of GDP in the amount similar to the European Unity, while comparing to the countries of the region, these funds were less only than in Bosnia and Herzegovina. This allocating of financial resources in total, however, was low as the consequence of relatively low level of GDP in Serbia. Conclusion. Establishing NHA provided a pattern of national healtcare spending and allowed a comparison of healthcare system in Serbia with the systems of other countries. analyzing a period 2003-2006 revealed a similarity between Serbia and the countries of the European Unity in regard to the level of average financial resources allocation for healthcare expressed as a percentage of GDP, as well as in regard to financiers in the system of healthcare. A high purchasing power disparity, however, in healthcare services was observed between the population of Serbia and other European countries.Uvod/Cilj. Glavni cilj zdravstvene politike svake zemlje jeste postizanje finansijske održivosti samog zdravstvenog sistema, kao i obezbeđenje veće dostupnosti zdravstvenim uslugama celom stanovništvu. U ostvarivanju ovog cilja zemlje Evropske unije ustanovile su i u svoje zdravstvene sisteme implementirale Nacionalne zdravstvene račune (NZR). Kao alatka za menadžment u zdravstvu na osnovu dokaza, NZR pruža podatke o finansijskim tokovima u zdravstvu na nacionalnom nivou i omogućuje međunarodno poređenje. Cilj ovog rada bio je da se pomoću NZR ispitaju finansijski tokovi u zdravstvenom sistemu Republike Srbije, utvrdi obrazac zdravstvene potrošnje i odrede zdravstveni indikatori koji će omogućiti poređenje zdravstvenog sistema Srbije sa sistemima drugih zemalja. Metode. Izvršena je retrospektivna analiza zdravstvenih i finansijskih statističkih podataka iz završnih izveštaja relevantnih državnih institucija u periodu od 2003. do 2006. godine. Mnogostruki izvori podataka o zdravstvenoj potrošnji analizirani su po metodologiji NZR i uputstvu Organisation for Economic, Cooperation and Development (OECD) 'System of Health Accounts (SHA)' Version 1.0. Rezultati. Ukupna izdvajanja za zdravstvo činila su 8,6% bruto domaćeg proizvoda (BDP) u 2003. godini, 8,3% BDP u 2004, 8,7% BDP u 2005. i 9% BDP u 2006. godini. Republički zavod za zdravstveno osiguranje (RZZO) bio je predominantni finansijer u javnom sektoru finansijera u zdravstvu sa 93% učešća u 2006. godini. Najveći deo finansijskih sredstava usmeravan je u bolnice i za usluge lečenja. Izdvajanje po glavi stanovnika u 2006. godini u Srbiji bilo je 356 dolara. Od ukupnih sopstvenih sredstava, stanovništvo Srbije finansiralo je državne ustanove sa 21,28%, što iznosi 7,3% od ukupnih rashoda za zdravstvo, a privatne sa 78,72%, što iznosi 27% od ukupnih rashoda za zdravstvo. Srbija je 2006. godine imala slična izdvajanja BDP sa prosekom Evropske unije, a od zemalja u regionu manje je izdvajala od Bosne i Hercegovine. Međutim, ova izdvajanja u apsolutnom iznosu predstavljaju mala sredstva, što je posledica relativno niskog nivoa BDP Srbije. Zaključak. Uspostavom NZR utvrđen je obrazac zdravstvene potrošnje u Republici Srbiji i omogućeno je poređenje njenog zdravstvenog sistema sa sistemima drugih zemalja. U periodu 2003-2006. godina uočena je sličnost između Srbije i zemalja Evropske unije u visini prosečnih izdvajanja za zdravstvenu zaštitu, iskazana kao procenat od BDP, kao i u odnosu finansijera u zdravstvenom sistemu. Međutim, utvrđen je veliki disparitet u kupovnoj moći zdravstvenih usluga između stanovništva Srbije i stanovništva ostalih evropskih zemalja

Ocena ostvarivanja prava osiguranih lica na preventivne stomatološke preglede u primarnoj zdravstvenoj zaštiti u Republici Srbiji u periodu 2003-2006. godine

Introduction. The dental health sector reform in Serbia has commenced in order to implement health policy changes. Assessment of legally regulated citizens rights to preventive dental examination, revision of those rights and their promotion are one of the dental health reform priorities. Objective. The objective of this study was to assess the utilization of preventive dental examination (PDE) in Serbia in 2006 among different subject groups and different districts and to analyze financial resources spent for those measures. Also, study aims were to compare the utilization of rights to preventive dental examination in Republic of Serbia in period between 2003-2006. Methods. The retrospective analytical study of Public Health Institute and Republican Statistical Office data were conducted. The comparative analytical method was used for assessment of preventive dental examinations within the given time frame from 2003 to 2006. Results. Results achieved in realization of PDE show a broad spectre of district discrepancies. The variation factor depending on preventive examination or population group it is related to varies from 26.73% to 90.88%. Conclusion. Realization of preventive dental examinations in the Republic of Serbia was significantly lower than projected in the period 2003-2006.Uvod. Reforma stomatološkog zdravstvenog sektora u Srbiji počela je kako bi se usvojile i primenile promene u zdravstvenoj politici. Korišćenje zakonski regulisanih prava građana na preventivne stomatološke preglede (PSP), njihova revizija i promocija prava građana prioriteti su ove reforme. Cilj rada. Cilj istraživanja je bio da se u različitim okruzima u Srbiji proceni stepen realizacije PSP planiranih u 2006. godini kod različitih populacionih grupa i analizira dinamika ostvarivanja prava na preglede u periodu 2003-2006. godine. Metode rada. Ova retrospektivno-analitička studija urađena je na osnovu podataka Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' i Republičkog zavoda za statistiku. Za procenu realizacije PSP u posmatranom periodu korišćena je komparativna analitička metoda. Rezultati. Stepen realizacije PSP se razlikuje po regionima Srbije. Razlike zavise od vrste PSP i uzrasta ispitanika, a u rasponu su od 26,73% do 90,88%. Zaključak. Realizacija PSP u primarnoj zdravstvenoj zaštiti u Republici Srbiji tokom perioda 2003-2006. godine je daleko ispod predviđenog i planiranog obima

Stanje zdravstvenog sistema Republike Srbije u periodu 2004-2012. godine

Introduction The backbone of Serbian health system forms the public healthcare provider network with 355 institutions and around 112,000 employees, owned and controlled by the Ministry of Health and financed mainly by the Republican Health Insurance Fund. The law recognizes private practice that was not included, till recently, in the public funding scheme. New Health Insurance Law (2005) decreased the number of entitlements in the basic health service package. It abolished the right to dental health care for adults (exceptions are: children, older than 65, pregnant women and emergency cases) as well as the right to compensate travel expenses. The aim of this study was to evaluate the effects of health care system of the Republic of Serbia and indicate parameters that determine the state of health of the population, on the ground of data obtained by the Institute of Public Health of Serbia. Results In the period 2004-2012, cardiovascular diseases represented the main cause of illness in Serbia (50%). In 2012 digestive system diseases were on the second place. Neoplasm and nervous system diseases were on the third place. From 2007 to 2012 there was slight decline in the birth rate and number of deaths, but the death rate increased from 13.9 to 14.2. Health care system in Serbia is funded through the combination of public finances and private contributions. Primary care is provided in 158 health care centres and health care stations, secondary and tertiary care services are offered in general hospitals, specialized hospitals, clinics, clinico-hospital centers and clinical centres. Conclusion A significant but not satisfactory progress has been achieved in the field of health status indicators as the most important outcome of the final performance of the health system. The transition of public health care system in Serbia since the communist period to present and slow integration with European Union is unfinished process.Uvod Osnovicu zdravstvenog sistema Republike Srbije čini zdravstvena mreža od 355 državnih zdravstvenih ustanova i oko 112.000 zaposlenih koji su pod kontrolom Ministarstva zdravlja, a finansiraju se preko Republičkog fonda zdravstvenog osiguranja. Zakon poznaje i privatni sektor, koji doskora nije bio uključen u shemu javnog finansiranja. Zakon o zdravstvenom osiguranju iz 2005. godine smanjio je prava u osnovnom zakonu zdravstvenih usluga i ukinuo pravo na stomatološku zdravstvenu zaštitu (s izuzetkom dece, osoba starijih od 65 godina, trudnica i hitnih slučajeva), odnosno pravo na naknadu putnih troškova u vezi s ostvarivanjem prava na zdravstvenu zaštitu. Cilj ovog rada je bio da se na osnovu podataka Instituta za javno zdravlje Srbije 'Dr Milan Jovanović Batut' procene efekti zdravstvenog sistema Republike Srbije i ukaže na parametre ovoga sistema koji određuju stanje zdravlja stanovništva. Rezultati Od 2004. do 2012. godine kardiovaskularne bolesti su bila najčešća oboljenja u Srbiji (50%). U 2012. godini bolesti digestivnog sistema bile su na drugom mestu. Na trećem mestu su maligne i bolesti nervnog sistema. U periodu 2007-2012. zabeležen je i blag pad nataliteta, smanjio se i broj smrtnih slučajeva, ali je stopa mortaliteta porasla sa 13,9 na 14,2. Sistem zdravstvene zaštite u Srbiji se finansira kroz kombinaciju državnih finansija i privatnih doprinosa. Primarna zdravstvena zaštita se odvija u 158 domova zdravlja, zdravstvenih stanica i ambulanti, a sekundarne i tercijarne službe rade u opštim i specijalnim bolnicama, institucijama, klinikama i kliničko- bolničkim centrima. Zaključak Značajan, ali nedovoljan, napredak postignut je u oblasti pokazatelja zdravstvenog stanja, kao najvažnijeg konačnog ishoda učinka zdravstvenog sistema. Tranzicija državnog sistema zdravstvene zaštite u Srbiji od komunističkog perioda do danas i usporeno integrisanje s Evropskom Unijom je nedovršen proces

Radna snaga u javnom sektoru zdravstvenog sistema Republike Srbije i svetska ekonomska kriza

Introduction. Health care, as one of the most important and sensitive fields of human endeavor, has a significant social impact; therefore changes in this area have wide implications on society in general. The latest economic crisis resulted in slow growth of gross domestic product (GDP), high unemployment rates, low living standards, and increased poverty across the globe. This includes decreased capacity of health system, and reduced quality and supply of health services. The aim of the study was to explore possible impact of the current world economic crisis on the public health sector workforce in Serbia. Materials and Methods. The study was conducted as retrospective analyses of the Public Health Institute (PHI) human resource data, the Republic Statistical Office publications and database, the Republic Development Bureau report, as well as the analysis of healthcare expenditures obtained from the Chamber of Health Institutions reports. The comparative analytical method was used for the assessment of socio-economic and human resource indicators over the period of five years, 2006 to 2010. Results. Results showed that the world economic crisis discontinued steady economic growth in Serbia. Between 2006 and 2008, the real GDP growth rate has been fluctuating between 3.6% and 5.4 %, while in 2009 it had negative growth rate of -3.1 % and slight increase in 2010 of 1.0%. In 2006, the GDP per capita was US$3,943, and by 2008 it almost doubled reaching US$ 6,498, while in 2009 it fell down to US$5,499, and continued decrease in 2010 to US$ 5,006. In 2007, the overall inflation rate was 6.5%, and after fluctuaion between 11.7% in 2008 and 8.4% in 2009 it droped again to 6.5% in 2010. According to the PHI, from 2006 to 2008 there was steady increase of full-time employees in the public health care sector; from 108,975 in 2006 to 114,317 in 2008. In 2009, the number of full-time employees slightly declined to 114,175 and 114,432 in 2010. There was constant increase in total number of employees in the public health care sector, from 125,081 in 2006 to 129,357 in 2008. In 2009, the total number of employees decreased to 128,694 and in 2010 to 122,695. At the same time, the total expenditure of human resources in the health sector as the percentage of total health expenditure declined from 37.7% in 2006 to 34.7% in 2010. The public health sector salaries after steady increase from 59.9% of total health expenditure in 2006 to 61.2% in 2007 and 2008, decreased to 56.2% in 2010. The unemployment rate for medical doctors almost doubled in 2010 as compared to 2006. Conclusion. Preliminary study results showed that the world economic crisis had negative impact not only on GDP growth rate, the inflation and unemployment rate, but on the public health sector workforce, their salaries and unemployment rate in Serbia.Uvod. Zdravstvena zaštita, kao jedna od najvažnijih i osetljivijih oblasti ljudskog delovanja, ima značajnu društvenu funkciju, pa promene u ovoj oblasti imaju široke implikacije na društvo u celini. Najnovija ekonomska kriza dovela je do sporog rasta bruto domaćeg proizvoda (BDP), visoke stope nezaposlenosti, nižeg životnog standarda i povećanja broja siromašnih širom sveta. Ovo uključuje i smanjenje kapaciteta zdravstvenog sistema, odnosno smanjenje obima i kvaliteta pruženih zdravstvenih usluga. Cilj rada bio je da se procene mogući uticaji svetske ekonomske krize na radnu snagu u javnom sektoru zdravstvenog sistema Republike Srbije. Materijal i metode rada. Retrospektivno su analizirani podaci o ljudskim resursima Instituta za javno zdravlje Srbije (IZJZS), baze podataka i publikacije Republičkog zavoda za statistiku, Republičkog fonda za razvoj, izveštaji Republičkog zavoda za tržište rada i podaci o zdravstvenim rashodima dobijeni iz izveštaja Komore zdravstvenih ustanova. Komparativna analitička metoda je korišćena za procenu socioekonomskih indikatora i kretanja ljudskih resursa tokom petogodišnjeg perioda (2006-2010. godine). Rezultati. Studija je pokazala da je svetska ekonomska kriza prekinula konstantan privredni rast u Srbiji. Između 2006. i 2008. godine realna stopa rasta BDP je fluktuirala između 3,6% i 5,4%, dok je u 2009. imala negativnu stopu rasta od -3,1% i blagi porast od 1% u 2010. U 2006. godini BDP po stanovniku bio je 3.943 američka dolara, a 2008. skoro dvostruko veći, dostigavši 6.498 dolara, dok je u 2009. pao na 5.499 dolara i nastavio da se smanjuje do 5.006 dolara u 2010. U 2007. godini ukupna inflacija bila je 6,5%, a posle fluktuiranja između 11,7% u 2008. i 8,4% u 2009, da bi se u 2010. ponovo smanjila na 6,5%. Prema podacima IZJZS, od 2006. do 2008. godine zabeleženo je stalno povećanje broja zaposlenih u javnom sektoru zdravstva sa 108.975 na 114.317. U 2009. broj stalno zaposlenih neznatno se smanjio na 114.175, odnosno na 114.432 u 2010. godini. Primećeno je konstantno povećanje ukupnog broja zaposlenih u javnom sektoru zdravstva, sa 125.081 u 2006. na 129.357 u 2008. U 2009. godini ukupan broj zaposlenih je smanjen na 128.694, a u 2010. na 122.695. Istovremeno, ukupni rashodi za ljudske resurse u javnom sektoru zdravstvenog sistema u odnosu na ukupne troškove za zdravstvenu zaštitu smanjeni su sa 37,7% u 2006. na 34,7% u 2010. Zarade zaposlenih u javnom sektoru zdravstvenog sistema Republike Srbije su se posle neprekidnog povećanja od 59,9% ukupnih troškova lečenja u 2006, preko 61,2% u 2007. i 2008. godini, smanjile na 56,2 % u 2010. Stopa nezaposlenosti za lekare se skoro udvostručila u 2010. u poređenju sa 2006. godinom. Zaključak. Preliminarni rezultati studije su pokazali da je svetska ekonomska kriza loše uticala ne samo na stopu rasta BDP, inflaciju i nezaposlenost, već i na javni zdravstveni sektor, radnu snagu, plate i stopu nezaposlenosti u Republici Srbiji

Health care marketing: Basic features

Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation