Web-economic-crisis-health-systems-and-health-web
Web-economic-crisis-health-systems-and-health-web Web-economic-crisis-health-systems-and-health-web
Country profiles of health system responses to the crisis | Slovakia 479 % Slovakia: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 −20 −25 −30 _ _ _ _ ● ● _ _ _ _ _ _ _ _ ● _ ● ● _ _ Real GDP per capita growth _ _ ● ● _ _ _ _ _ _ _ ● ● ● _ _ _ Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) _ _ _ _ _ _ _ ● _ ● ● ● ● _ _ _ 10−year bond rates _ _ _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Unemployment rate Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators: WHO Health for All. Year 2000−2007 2008 2009 2010 2011 Slovakia: Fig. 2 Trends in per capita spending on health, 2000–2011 Public spending per capita OOP spending per capita Non−OOP private spending per capita Per capita spending $, PPP 1000 500 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 150 Growth % 100 50 0 30 Growth % 20 10 0 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
480 Economic crisis, health systems and health in Europe: country experience User charges • Introduction of an annual cap on OOP payments for drugs for vulnerable groups (€30 for disabled or older people, €45 for people with low income) (2011). Changes to health service planning, purchasing and delivery Prices of medical goods • Introduction of reference pricing (2009–2010) and subsequent adoption of stricter benchmarking for drug pricing, making its reference pricing the second lowest in the EU (2011). Salaries and motivation of health sector workers • Increase in salaries of nurses and hospital physicians through the setting of national minimum wages (2011) (but increase in nurses' salaries is currently being challenged in the Constitutional Court by the Slovak Chamber of Physicians). Payment to providers • Started work on DRG implementation in 2011 in order to increase efficiency but the project was postponed to 2016. • Introduction of mandatory publication of contracts in the public sector to allow better monitoring and public inspection of procurement of goods and services in the health system (2011). Overhead costs: restructuring the Ministry of Health and purchasing agencies • Two state-owned health insurance companies (Common Health Insurance Company and General Health Insurance Company) merged (2010). The aim was to address an acute lack of funding leading to delayed payments to pharmacies and providers. The merger secured €65 million from the state budget and another approximately €33 million from the financial reserves of the Common Health Insurance Company. • Introduction of a formula for the calculation of the limit of health insurance companies' administrative costs (2011). • Health insurance companies reduced the number of their staff by 10% between 2010 and 2011. Provider infrastructure and capital investment • Reduction (by up to 10%) of hospital beds by the largest health insurance company, the state-owned VšZP (2011). The optimization of the hospital care network was designed to promote facilities with better quality outcomes, to enhance effectiveness and to support day surgery.
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Country profiles of <strong>health</strong> system responses to the <strong>crisis</strong> | Slovakia<br />
479<br />
%<br />
Slovakia: Fig. 1 Economic <strong>and</strong> fiscal indicators 2000–2007 <strong>and</strong> 2008–2011<br />
60<br />
55<br />
50<br />
45<br />
40<br />
35<br />
30<br />
25<br />
20<br />
15<br />
10<br />
5<br />
0<br />
−5<br />
−10<br />
−15<br />
−20<br />
−25<br />
−30<br />
_ _<br />
_ _<br />
● ●<br />
_ _<br />
_ _<br />
_ _ _<br />
_<br />
●<br />
_<br />
●<br />
●<br />
_ _<br />
Real GDP<br />
per capita growth<br />
_ _<br />
● ●<br />
_<br />
_ _ _ _<br />
_ _<br />
●<br />
● ●<br />
_ _ _<br />
Deficit/surplus<br />
(% GDP)<br />
_ _ _ _ _ _ _ _<br />
_ _<br />
●<br />
●<br />
_ _<br />
_<br />
● _ ●<br />
_<br />
●<br />
_ _ _ _ _<br />
Government<br />
spending<br />
(% GDP)<br />
_ _ _ _ _<br />
● ● ● ● ●<br />
_ _ _ _ _<br />
Government<br />
<strong>health</strong> spending<br />
(% total government<br />
spending)<br />
_ _ _ _ _<br />
_ _ ● _ ●<br />
●<br />
●<br />
●<br />
_ _ _<br />
10−year<br />
bond rates<br />
_ _ _ _<br />
_ _<br />
_ _<br />
_<br />
●<br />
●<br />
●<br />
●<br />
●<br />
_ _ _ _ _<br />
Unemployment<br />
rate<br />
Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators:<br />
WHO Health for All.<br />
Year<br />
2000−2007 2008 2009 2010 2011<br />
Slovakia: Fig. 2 Trends in per capita spending on <strong>health</strong>, 2000–2011<br />
Public spending per capita OOP spending per capita Non−OOP private spending per capita<br />
Per capita spending $, PPP<br />
1000<br />
500<br />
0<br />
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
150<br />
Growth %<br />
100<br />
50<br />
0<br />
30<br />
Growth %<br />
20<br />
10<br />
0<br />
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />
Public spending<br />
per capita growth<br />
OOP spending<br />
per capita growth<br />
Note: Spending calculated from WHO Health for All.<br />
Non−OOP private spending<br />
per capita growth
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