Ivanković A, Rebac Z
Mostar University Hospital and School of Medicine, Bijeli brijeg bb, 88000 Mostar, Bosnia and Herzegovina.
Croat Med J. 1999 Jun;40(2):166-74.
Financing dental health care in the Federation of Bosnia and Herzegovina (FBH) over the last 10 years was analyzed with respect to time before the war, during the 1992-1995 war, and after the war. In the first period (until 1991) the system was centralized, well structured, financed through the communities of interest, and burdened with a lack of financial discipline and high inflation. By the end of 1991, all citizens in the territory of BH Federation had the right to dental health insurance and participated in the price of dental service with 10-50%. During the 1992-1995 war, insurance and financial institutions ceased their work until the establishment of civilian governing authorities. The system of dental services was legalized within the health system as its integral part, yet, because of insufficient financial support, the rights of the insured were not fulfilled. Following the Dayton Peace Agreement in 1995, two systems (Croat and Muslim) were in function in FBH, each based on different legal grounds, and dental care stagnated considerably. The 1997 FBH Law on Health Care and Health Insurance and the Law on the Privatization of companies introduced a unique health system, widening the sources of financing and categories of health insurance. The process of health care privatization has been legalized, but not yet implemented. Lack of definitions of ownership diminish foreign investments, and without foreign financial support the improvements will be slower than needs. The process of health care restructuring will thus directly depend on the solving the political crisis in the country.
对波斯尼亚和黑塞哥维那联邦(波黑联邦)过去10年的牙科医疗保健融资情况,根据战前、1992 - 1995年战争期间以及战后的时间进行了分析。在第一个时期(直到1991年),该体系是集中化的,结构完善,通过利益共同体融资,并且存在财务纪律缺失和高通胀的问题。到1991年底,波黑联邦境内的所有公民都有权享受牙科医疗保险,并支付10% - 50%的牙科服务费用。在1992 - 1995年战争期间,保险和金融机构停止运作,直到文职管理当局成立。牙科服务体系在卫生系统内合法化,成为其组成部分,然而,由于财政支持不足,被保险人的权利未能得到实现。1995年《代顿和平协定》签署后,波黑联邦有两个体系(克罗地亚族和穆斯林族体系)在运行,每个体系都基于不同的法律依据,牙科护理大幅停滞。1997年波黑联邦《医疗保健和健康保险法》以及公司私有化法引入了一个统一的卫生系统,拓宽了融资来源和健康保险类别。医疗保健私有化进程已经合法化,但尚未实施。所有权定义的缺失减少了外国投资,没有外国财政支持,改善速度将比需求的慢。因此,医疗保健重组进程将直接取决于该国政治危机的解决。