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Country profiles of health system responses to the crisis | TFYR Macedonia 435 % The former Yugoslav Republic of Macedonia: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 Year 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 _ _ _ _ ● ● _ _ _ _ ● _ _ _ _ _ ● ● _ _ Real GDP per capita growth Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) Notes: Deficit/surplus: Eurostat; Other indicators: WHO Health for All. 2000−2007 2008 2009 2010 2011 10−year bond rates _ _ _ ● ● ● _ ● _ _ _ _ ● _ _ _ _ _ _ Unemployment rate The former Yugoslav Republic of Macedonia: Fig. 2 Trends in per capita spending on health, 2000–2011 500 Public spending per capita OOP spending per capita Non−OOP private spending per capita Per capita spending $, PPP 400 300 200 100 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Growth % 20 0 −20 −40 15 Growth % 10 5 0 −5 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth
436 Economic crisis, health systems and health in Europe: country experience Changes to health service planning, purchasing and delivery Prices of medical goods • SHI introduced reference prices for drugs on a positive list based on drug prices in Bulgaria, Croatia, Serbia and Slovenia (2010). Salaries and motivation of health sector workers • Additional personnel recruitment (200 doctors, 60 nurses, 20 radiography and laboratory technicians) approved in response to migration issues (2011). Payment to providers • Health Insurance Fund introduced reference prices for health services (2009). The total value of contracts with health organizations in 2011 increased by 8.5% compared with 2010. Overhead costs: restructuring the Ministry of Health and purchasing agencies • No response reported. Provider infrastructure and capital investment • Increases in the quality of health services were sought by reorganizing emergency medical services, upgrading medical equipment, establishing a committee dedicated to the improvement of the health sector, and implementing an integrated health management information system and electronic health card (2010–2012). Priority setting or protocols to change access to treatments, coordination of care and patterns of use • The Ministry of Health and professional associations developed 240 evidence-based medicine clinical guidelines (2012) and health institutions are developing clinical pathways. Waiting times • No response reported. Health promotion and prevention • Adoption of 17 public health programmes (2012). • Reduction by 38% to preventive health programmes budget (2012).
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Economic crisis, health systems and
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The European Observatory on Health
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Keywords: DELIVERY OF HEALTH CARE E
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vi Economic crisis, health systems
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viii Economic crisis, health system
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List of abbreviations ACS Health in
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List of tables and figures Tables P
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xiv Economic crisis, health systems
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xvi Economic crisis, health systems
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xviii Economic crisis, health syste
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xx Economic crisis, health systems
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xxii Economic crisis, health system
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xxiv Economic crisis, health system
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xxvi Economic crisis, health system
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Acknowledgements This book represen
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Preface This book maps health polic
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Part I Country case studies
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4 Economic crisis, health systems a
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10 Economic crisis, health systems
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Chapter 4 The impact of the crisis
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Chapter 4 | The impact of the crisi
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Albania Genc Burazeri and Enver Ros
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Country profiles of health system r
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Austria Thomas Czypionka and Maria
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Azerbaijan Fuad Ibrahimov Economic
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Bulgaria Antoniya Dimova and Mina P
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Cyprus Elisavet Constantinou and Ma
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Czech Republic Tomáš Roubal and J
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Estonia Triin Habicht and Mall Lein
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Finland Jan Klavus and Lauri Vuoren
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France Karine Chevreul, Karen Berg
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Page 420 and 421: Germany Klaus-Dirk Henke and Wilm Q
Page 434 and 435: Iceland Sigrún Gunnarsdóttir and
Page 438 and 439: Ireland Anne Nolan and Steve Thomas
Page 444 and 445: Israel Bruce Rosen and Amir Shmueli
Page 452 and 453: Kazakhstan Ninel Kadyrova and Tata
Page 458 and 459: Latvia Uldis Mitenbergs and Maris T
Page 470 and 471: Malta Natasha Azzopardi Muscat Econ
Page 478 and 479: Montenegro Ratka Knežević Economi
Page 486 and 487: Norway Anne Karin Lindahl and Jon M
Page 504 and 505: The Russian Federation Elena Potapc
Page 508 and 509: Serbia Vukasin Radulovic Economic t
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Spain Enrique Bernal-Delgado, Sandr
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Switzerland Alberto Holly and Phili
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Tajikistan Ghafur Khodjamurodov Eco
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Ukraine Valeria Lekhan and Mariia T
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