Krstic Kristijan, Janicijevic Katarina, Timofeyev Yuriy, Arsentyev Evgeny V, Rosic Gvozden, Bolevich Sergey, Reshetnikov Vladimir, Jakovljevic Mihajlo B
Center for Rehabilitation Medicine, University Clinical Center Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Front Public Health. 2019 Dec 13;7:381. doi: 10.3389/fpubh.2019.00381. eCollection 2019.
Serbia is an upper-middle income Eastern European economy. It has inherited system of health provision and financing, which is a mixture of Soviet Semashko and German Bismarck models. So far, literature evidence on long-term trends in health spending remains scarce on this region. Observational descriptive approach was utilized relying on nationwide aggregate data reported by the Republic Health Insurance Fund (RHIF) and the Government of Serbia to the WHO office. Consecutively, the WHO Global Health Expenditure Database was used. Long-term trends were extrapolated on existing data and underlying differences were analyzed and explained. The insight was provided across two distinctively different periods within 2000-2016. The first period lasted from 2000 till 2008 (the beginning of global recession triggered by Lehman Brothers' bankruptcy). This was a period of strong upward growth in ability to invest in health care. Spending grew significantly in terms of GDP share, national and per capita reported expenditures. During the second period (2009-2016), after the beginning of worldwide economic crisis, Serbia was affected in a way that its health expenditure growth in PPP terms slowed down effectively fluctuating around plateau values from 2014 to 2016. Serbia health spending showed promising signs of steady growth in its ability to invest in health care. Consolidation marked most of the past decade with certain growth rates in recent years (2017-2019), which were not captured in these official records. The future national strategy should be devised to take into account accelerated population aging as major driver of health spending.
塞尔维亚是东欧的一个中高收入经济体。它继承了医疗服务和融资体系，这是苏联谢马什科模式和德国俾斯麦模式的混合体。到目前为止，关于该地区卫生支出长期趋势的文献证据仍然很少。本研究采用观察性描述方法，依据塞尔维亚共和国健康保险基金（RHIF）和塞尔维亚政府向世界卫生组织办事处报告的全国汇总数据。随后，使用了世界卫生组织全球卫生支出数据库。根据现有数据推断长期趋势，并分析和解释潜在差异。研究洞察了2000年至2016年两个截然不同的时期。第一个时期从2000年持续到2008年（由雷曼兄弟破产引发的全球衰退开始）。这是一个在医疗保健投资能力方面强劲增长的时期。从GDP占比、国家和人均报告支出来看，支出显著增长。在第二个时期（2009 - 2016年），全球经济危机开始后，塞尔维亚受到影响，其按购买力平价计算的卫生支出增长放缓，在2014年至2016年期间实际上围绕平稳值波动。塞尔维亚的卫生支出显示出在医疗保健投资能力方面稳步增长的良好迹象。在过去十年的大部分时间里，塞尔维亚呈现出巩固态势，近年来（2017 - 2019年）有一定的增长率，但这些未被这些官方记录所涵盖。未来的国家战略应考虑到人口加速老龄化这一卫生支出的主要驱动因素而制定。
