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