Sustainability of Healthcare Financing in the Western Balkans : An Overview of Progress and Challenges
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World Bank, Washington, DC
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This paper explores the major challenges
to the sustainability of health sector financing in the
countries of the Western Balkans - Albania, Bosnia and
Herzegovina, the Former Yugoslav Republic of Macedonia,
Montenegro, Serbia and the province of Kosovo. It focuses on
how the incentives created by the different elements of the
healthcare financing system affect the behavior of
healthcare providers and individuals, and the resulting
inefficiencies in revenue collection and expenditure
containment. The paper analyzes patterns of healthcare
expenditure, finding that there is some evidence of cost
containment, but that current expenditure levels - while
similar to that in EU countries as a share of GDP - are low
in per capita terms and the fiscal space to increase
expenditures is extremely limited. It also examines the key
drivers of current healthcare expenditure and the most
significant barriers to revenue generation, identifying some
key health reforms that countries in the sub-region could
consider in order to enhance the efficiency and
sustainability of their health systems. Data are drawn from
international databases, country institutions, and household surveys.
Palabras clave
BARRIERS TO REVENUE GENERATION, FISCAL SPACE, EXPENDITURE CONTAINMENT, HEALTHCARE PROVIDERS, HEALTH FINANCING SUSTAINABILITY, HEALTH SYSTEM EFFICIENCY, INCENTIVES, REVENUE COLLECTION