Croatian medical journal
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Croatian medical journal · Sep 1998
Priority setting and scarce resources: case of the Federation of Bosnia and Herzegovina.
The priority setting within the context of scarce resources in the Federation of Bosnia and Herzegovina (BH) can be divided into priorities within the health care services provision and priorities within the reconstruction process. Facing the resource scarcity, the Federation of BH has chosen to increase health insurance contribution rate to establish cost-sharing arrangements (co-payments) and priority setting to ration access to certain services funded by the compulsory health insurance ("basic package" of the health care services). Reconstruction process of the health care facilities is conducted on the federal level through the effective managerial infrastructure ("project implementation units"). This study reports on the consequences of the war in BH as a peculiar context of the overall reform objectives and priority setting.
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Assessment of the Croatian health care system (under the reform) from the perspective of the users of health care services. We analyzed the consumers' satisfaction with health care system, health care expenses and access, and described the consumers' attitudes toward health reform, examining the differences among sociodemographic groups. ⋯ Croatian government decided to rationalize the health care system without taking much account of the impact of health reform on the consumers. Revealed dissatisfaction with the health care services might be linked with the expressed doubts in health care reform and concern that changes could worsen the consumers' position as patients.