Healthcare in Serbia
Healthcare in Serbia is delivered by means of a universal health care system, although corruption, inefficiency, and a physician shortage are major problems.
The healthcare system is managed by the National Health Insurance Fund, which covers all citizens and permanent residents. All employees, self-employed persons, and pensioners must pay contributions to it. Contributions are based on a sliding scale, with wealthier members of society paying higher percentages of their income. Despite this, corruption remains a serious problem due to low salaries, with many doctors demanding bribes in exchange for better treatment, although there is a major campaign against corruption from the government and NGOs.
In 2011, there was 1 physician for every 344 inhabitants, and 5.7 hospital beds for every 1,000 inhabitants.
Changes in the healthcare system
In the past few decades, there have been numerous changes in the healthcare system that were set up when Serbia was a Republic of Yugoslavia. During those years, healthcare was free but practically unavailable to all people, there were no fixed prices, and services were often abused. Today, reforms have mandated but failed to implement a basic level of health services for all people, but at varying levels or co-payment. Services not covered may be supplemented by private insurance. Current concerns in the field of Serbian healthcare, as reported by the medical staff providing care, are poor funding for primary care, inadequate equipment and supplies, inadequate salaries, and inadequate continuing medical education. Overall, the recent healthcare reforms have tried to change the emphasis from curative to preventative care.
The government elected on 27 April 2014 is said to be making a sincere effort to reform the healthcare system. The Chairperson of “Doctors Against Corruption” has been appointed a Special Adviser to the Ministry of Health.
Culture of healthcare in Serbia
The culture of healthcare in Serbia may be considered very corrupt. Self care is mainly practiced when a patient is already ill versus as a preventative measure. Care is usually sought from healthcare professionals such as doctors or nurses where bribes are commonly expected, but some folk medications are used such as teas, vinegar, herbs, and vitamins. Changes in activity levels such as more rest or increased exercise are sometimes used as curative measures for illness, and perceived causes of illness may be improper diet or fate. Hjelm, Bard, Nyberg, and Apleqvist (2005) state that most former Yugoslavians feel health is not the absence of disease, but rather it is “wealth and the most important thing in life…to have enough strength” (p. 51).
In 2015 it was estimated that 11.96% of the population has diabetes, costing about $666 per person per year.
- Kunitz, 2004
- Nelson et al., 2003
- McCarthy, 2007
- "Outcomes in EHCI 2015" (PDF). Health Consumer Powerhouse. 26 January 2016. Retrieved 27 January 2016.
- Hjelm, Nyberg, Isacsson, & Apelqvist, 1999
- Hjelm et al., 1999
- "Top 10: Which country has the highest rates of diabetes in Europe? The UK's position might surprise you…". Diabetes UK. 27 August 2015. Retrieved 20 December 2015.
- Nelson, B.D., Simic, S., Beste, L., Vukovic, D., Bjegovic,V., & VanRooyen, M.J. (2003). Multimodal assessment of the primary healthcare system of Serbia: A model for evaluating post conflict health systems. Prehospital and Disaster Medicine, 18(1), 6-13
- Hjelm, K., Nyberg, P., Isacsson, A., & Apelqvist, J. (1999). Beliefs about health and illness essential for self-care practice: a comparison of migrant Yugoslavian and Swedish diabetic females. Journal of Advanced Nursing, 30(5), 1147-1159.
- Hjelm, K.G., Bard, K., Nyberg, P, & Apelqvist, J. (2005). Beliefs about health and diabetes in men of different ethnic origin. Journal of Advanced Nursing, 50(1), 47-59.
- McCathy, M. (2007). Serbia rebuilds and reforms its health-care system. Lancet, 369, 360.
- Kunitz, S.J. (2004). The making and breaking of Yugoslavia and its impact on health. American Journal of Public Health, 94(11), 1894-1904.
- Vlajinac, H., Marinkovik, J., Kocev, N., Sipetic, S., Bjegovic, V., Jankovic, S.,…Maksimivic, J. (2008). Years of life lost due to premature death in Serbia (excluding Kosovo and Metohia). Journal of the Royal Institute of Public Health, 122, 277-284.