Sabanović Z, Masić I
Medicinski fakultet Tuzla.
Med Arh. 1998;52(2):93-5.
Improvement of the efficiency and effectivity of health care system is a task of high priority for social system because it is one of its crucial components. Health care system spends significantly great part of social budget. That is why its quality--directly or indirectly--influences other segments of social system. After five years of either total or partial destruction of health care capacities, facilities, resources, lack of human resources, as well due to total collapse of the economy in our country, the consequences of the aggression on Bosnia and Herzegovina require radical changes in respect of the organisation and structure of the health care system in Bosnia and Herzegovina. Concerning the fact that hospital system in Bosnia and Herzegovina is one of the most expensive segments of health care system, future reforms in health care system should be implemented primarily in this field. These reforms should consist of establishing of DRG system for control, evaluation, updating, financing and management of health care system to desired direction and way of development. In that regard, it is necessary to: improve actual computer capacities by application of new technologies; develop DRG and CASEMIX classification systems, following experiences of highly developed countries, and adapt it to our health care system; change financing system by following CASEMIX, and adapt CASEMIX step-by-step to implementation i.e.: department by department; hospital by hospital; in the last phase-to connect CASEMIX with network of integral information system of Sarajevo Canton and, later, with network of all other cantons in BiH. to educate medical staff about the implementation and use of DRG and CASEMIX in practice.
提高医疗保健系统的效率和效能是社会系统的一项高度优先任务，因为它是社会系统的关键组成部分之一。医疗保健系统在社会预算中占相当大的比例。这就是为什么其质量会直接或间接地影响社会系统的其他部分。在我国医疗保健能力、设施、资源遭到全面或部分破坏五年之后，加上人力资源匮乏以及经济全面崩溃，波斯尼亚和黑塞哥维那遭受侵略的后果要求对该国医疗保健系统的组织和结构进行彻底变革。鉴于波斯尼亚和黑塞哥维那的医院系统是医疗保健系统中最昂贵的部分之一，未来医疗保健系统的改革应主要在这一领域实施。这些改革应包括建立诊断相关分组（DRG）系统，以控制、评估、更新医疗保健系统，并将其资金和管理导向期望的发展方向和方式。在这方面，有必要：通过应用新技术提高现有计算机能力；借鉴高度发达国家的经验，开发DRG和病例组合（CASEMIX）分类系统，并使其适应我们的医疗保健系统；按照病例组合改变融资系统，并逐步使病例组合适应实施，即：逐个部门；逐个医院；在最后阶段——将病例组合与萨拉热窝州的综合信息系统网络连接起来，随后与波黑所有其他州的网络连接起来。对医务人员进行关于在实践中实施和使用DRG和病例组合的培训。
