Jakovljevic Mihajlo Michael, Arsenijevic Jelena, Pavlova Milena, Verhaeghe Nick, Laaser Ulrich, Groot Wim
a Health Economics and Pharmacoeconomics, Faculty of Medical Sciences , University of Kragujevac , Kragujevac , Serbia.
b Department of Health Services Research , CAPHRI, Maastricht University Medical Centre, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht , The Netherlands.
J Med Econ. 2017 May;20(5):483-492. doi: 10.1080/13696998.2016.1277228. Epub 2017 Jan 17.
Inter-regional comparison of health-reform outcomes in south-eastern Europe (SEE).
Macro-indicators were obtained from the WHO Health for All Database. Inter-regional comparison among post-Semashko, former Yugoslavia, and prior-1989-free-market SEE economies was conducted.
United Nations Development Program Human Development Index growth was strongest among prior-free-market SEE, followed by former Yugoslavia and post-Semashko. Policy cuts to hospital beds and nursing-staff capacities were highest in post-Semashko. Physician density increased the most in prior-free-market SEE. Length of hospital stay was reduced in most countries; frequency of outpatient visits and inpatient discharges doubled in prior-free-market SEE. Fertility rates fell for one third in Post-Semashko and prior-free-market SEE. Crude death rates slightly decreased in prior-free-market-SEE and post-Semashko, while growing in the former Yugoslavia region. Life expectancy increased by 4 years on average in all regions; prior-free-market SEE achieving the highest longevity. Childhood and maternal mortality rates decreased throughout SEE, while post-Semashko countries recorded the most progress.
Significant differences in healthcare resources and outcomes were observed among three historical health-policy legacies in south-eastern Europe. These different routes towards common goals created a golden opportunity for these economies to learn from each other.
对东南欧（SEE）地区卫生改革成果进行区域间比较。
宏观指标取自世界卫生组织的全民健康数据库。对后塞米什科体系国家、前南斯拉夫国家以及1989年前实行自由市场体制的东南欧经济体进行区域间比较。
在1989年前实行自由市场体制的东南欧国家中，联合国开发计划署人类发展指数增长最为强劲，其次是前南斯拉夫国家和后塞米什科体系国家。后塞米什科体系国家削减医院床位和护理人员数量的政策力度最大。在1989年前实行自由市场体制的东南欧国家，医生密度增长幅度最大。大多数国家的住院时间缩短；在1989年前实行自由市场体制的东南欧国家，门诊就诊次数和住院出院次数增加了一倍。在后塞米什科体系国家和1989年前实行自由市场体制的东南欧国家，生育率下降了三分之一。在1989年前实行自由市场体制的东南欧国家和后塞米什科体系国家，粗死亡率略有下降，而在前南斯拉夫地区则有所上升。所有地区的预期寿命平均增加了4岁；1989年前实行自由市场体制的东南欧国家预期寿命最长。东南欧各地儿童和孕产妇死亡率均有所下降，后塞米什科体系国家取得的进展最为显著。
东南欧三种历史卫生政策遗产在医疗资源和成果方面存在显著差异。这些通向共同目标的不同路径为这些经济体相互学习创造了绝佳机会。
