Croatia has recognised the importance of prevention programmes in the field of public health, although their effectiveness is not satisfactory due to the low population response, which has a negative ...impact on the rationalisation of public spending. One of the possible solutions is to consider the stated preferences of the target population. Therefore, the main objective of this study is to evaluate the use of stated preference methods in improving public health prevention programmes. For the purpose of the study, a questionnaire was designed using three different methods - Discrete Choice Experiment (DCE), Contingent Rating method (CR) and Best-Worst Scaling method (BWS). This study shows that the attributes of the Croatian cervical cancer screening programme are significantly associated with the respondents' utility level, which in turn is related to women's response. Since BWS, DCE, and CR measure the same construct - utility - we can say that convergent validity partially confirms the external validity of the methods. The author concludes that it is necessary to implement market principles, i.e. the demand-side analysis using stated preference methods, in the planning, implementation and re-evaluation of public health programmes.
Zdravstvena pismenost u Republici Hrvatskoj Bobinac, Ana; Dukić Samaržija, Nikolina; Ribarić, Elizabeta
Revija za socijalnu politiku,
01/2023, Letnik:
29, Številka:
3
Journal Article, Paper
Recenzirano
Odprti dostop
Research shows that low levels of health literacy have negative consequences for the health of the individual and the community. The aim of the research is to establish the average level of health ...literacy in Croatia on a nationally representative sample and to identify characteristics that can be linked to particularly low levels of health literacy. The results show that the level of health literacy in Croatia, on average, is at the very border between problematic and adequate. Within the population, however, there are significant differences in the level of health literacy associated with the class, economic and social characteristics of individuals. Lower health literacy reflects in an individual‘s reluctance to respond to preventive screenings, keep weight below obesity levels, or exercise regularly. Our results suggest that raising the level of health literacy in Croatia should not rely primarily on media campaigns, because health information from the media is difficult for citizens to understand and use for the purpose of protection against diseases. Key words: health literacy, HLS-EU-16, public health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Croatia is faced with a low response to cancer-screening programs, especially the national cervical cancer screening program, which ultimately resulted in its suspension. If judged solely on the ...basis of revealed preferences, such a poor response would imply that the population assigns a low social value to preventive screening programs. However, the question arises as to whether revealed preferences (the population's response), in the case of the absence of response to a preventive program, provide insight into its value (utility). Therefore, the objective of this paper is to determine the value that respondents assign to different attributes of cervical screening and, in a broader sense, to decide whether the best-worst scaling (BWS) approach is appropriate for determining the marginal willingness to pay (MWTP) for public health programs. The MWTP for certain attributes of cervical cancer screening is derived from the results of a BWS study conducted in Primorje-Gorski Kotar County, Croatia. The cost function was estimated by regressing the conditional logit coefficients (level of utility) of three levels of the cost attribute on its corresponding values, that is, the hypothetical price. Because the sum of the MWTP corresponds with the market price of a gynecological examination in private practice, we conclude that the results obtained by the BWS confirm the revealed preferences (the market value of the service).
Croatia is faced with a low response to cancer-screening programs, especially the national cervical cancer screening program, which ultimately resulted in its suspension. If judged solely on the ...basis of revealed preferences, such a poor response would imply that the population assigns a low social value to preventive screening programs. However, the question arises as to whether revealed preferences (the population's response), in the case of the absence of response to a preventive program, provide insight into its value (utility). Therefore, the objective of this paper is to determine the value that respondents assign to different attributes of cervical screening and, in a broader sense, to decide whether the best-worst scaling (BWS) approach is appropriate for determining the marginal willingness to pay (MWTP) for public health programs. The MWTP for certain attributes of cervical cancer screening is derived from the results of a BWS study conducted in Primorje-Gorski Kotar County, Croatia. The cost function was estimated by regressing the conditional logit coefficients (level of utility) of three levels of the cost attribute on its corresponding values, that is, the hypothetical price. Because the sum of the MWTP corresponds with the market price of a gynecological examination in private practice, we conclude that the results obtained by the BWS confirm the revealed preferences (the market value of the service).
The purpose of this paper is to provide a theoretical overview of efficiency and equity and give insights in the Croatian health system. Using selected indicators, a basic descriptive review of ...efficiency and equity in the Croatian health system was made, with an added comparison to other countries of the European Union. Observed at the macro level, Croatia shows relatively good efficiency of its health system, even above the average of the comparable countries by health expenditure per capita, but still significantly below the most developed EU countries. Still, Croatia requires further reforms that would enhance the efficiency of its health system (especially at the hospital level), without sacrificing equity which is a fundamental right of all citizens in need of health care. Although in total only small proportion of the population perceived an unmet need for health care, Croatia reported much larger inequalities in unmet need among different socio-economic groups, between high and low educated population, between women and men and among different age groups.
Equitable provision of health care has been a longstanding goal in many European countries. Provision of such universal coverage comes with the problem of growing health expenditures that is ...recognized globally. This article argues that patient-centered care (PCC), which has become a new promising paradigm for cost-effective provision of health care, should also become the new paradigm in the public health decision-making. PCC relates to the notion that patients ' preferences, objectives and values should be considered in the process of decision-making and delivery of health care. If we apply the PCC paradigm to the public health issue, it can be argued that any public health program or health policy should be created and evaluated considering patients' preferences. Therefore, the aim of this paper is to elaborate the importance of preference elicitation in health care decision-making as a part of PCC.
Istrazivanja pokazuju da niska razina zdravstvene pismenosti ima negativne posljedice za zdravlje pojedinca i zajednice. Cilj istrazivanja je utvrditi prosjecnu razinu zdravstvene pismenosti u ...Republici Hrvatskoj na nacionalno reprezentativnom uzorku te identificirati obiljezja koja se mogu dovesti u vezu s posebno niskom razinom pismenosti. Rezultati pokazuju da se razina zdravstvene pismenosti u Hrvatskoj, u prosjeku, nalazi na samoj granici izmedu problematicne i adekvatne. Unutar populacije, medutim, postoje znacajne razlike u razini zdravstvene pismenosti povezane s klasnim, ekonomskim i socijalnim obiljezjima pojedinaca. Niza zdravstvena pismenost odrazava se u nevoljkosti pojedinca da se odazove na preventivne preglede, da zadrzi tezinu ispod razine pretilosti ili da redovito vjezba. Nasi rezultati sugeriraju da se podizanje razine zdravstvene pismenosti u Hrvatskoj ne bi smjelo oslanjati primarno na medijske kampanje jer je informacije o zdravlju iz medija gradanima tesko razumjeti i upotrijebiti u svrhu zastitite od bolesti. Kljucne rijeci: zdravstvena pismenost, HLS-EU-16, javno zdravstvo. Research shows that low levels of health literacy have negative consequences for the health of the individual and the community. The aim of the research is to establish the average level of health literacy in Croatia on a nationally representative sample and to identify characteristics that can be linked to particularly low levels of health literacy. The results show that the level of health literacy in Croatia, on average, is at the very border between problematic and adequate. Within the population, however, there are significant differences in the level of health literacy associated with the class, economic and social characteristics of individuals. Lower health literacy reflects in an individual's reluctance to respond to preventive screenings, keep weight below obesity levels, or exercise regularly. Our results suggest that raising the level of health literacy in Croatia should not rely primarily on media campaigns, because health information from the media is difficult for citizens to understand and use for the purpose of protection against diseases. Key words: health literacy, HLS-EU-16, public health.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Temeljna svrha doktorske disertacije je objediniti i produbiti spoznaje o važnosti uključivanja izrečenih preferencija i povezanih odabira pojedinaca u proces osmišljavanja, prilagodbe i provedbe ...preventivnih programa javne zdravstvene zaštite. Slijedom toga, osnovni cilj empirijskog djela ovog istraživanja je, korištenjem ekonomske teorije u svrhu mjerenja i vrednovanja izrečenih preferencija ciljne populacije, utvrditi metodološku i aplikativnu (utvrđivanje relevantnih čimbenika na strani potražnje za zdravstvenim uslugama) važnost i potrebitost vrednovanja izrečenih preferencija prilikom osmišljavanja, provedbe i evaluacije
preventivnih programa javne zdravstvene zaštite, kroz uporabu i usporedbu različitih metoda vrednovanja izrečenih preferencija.Iz navedenih razloga ispitivale su se preferencije žena iz ciljne populacije Nacionalnog programa ranog otkrivanja raka vrata maternice na području Primorsko-goranske županije te utjecaj pojedinih obilježja programa na razinu njihove korisnosti i formiranje odluka o odazivu na screening, koristeći tri različite metode vrednovanje izrečenih preferencija.
Istraživanjem je dokazano (koristeći metodu uvjetovanog ocjenjivanja) kako su različita obilježja Nacionalnog program ranog otkrivanja raka maternice povezana s razinom korisnosti ispitanika. Nadalje, koristeći eksperiment diskretnog odabira (DCE), utvrđeno je da su razine obilježja Programa povezane s odlukama žena o odazivu na screening, dok je metodom najboljeg i najgoreg odabira (BWS), osim promjene u razinama korisnosti unutar pojedinog obilježja (vrijednost skale), utvrđena i razina korisnosti između različitih obilježja Programa, odnosno relativni utjecaj pojedinih obilježja na korisnost ispitanika. Također,
istraživanjem je dokazana i mogućnost usporedbe graničnih korisnosti različitih obilježja prema homogenim grupacijama ispitanika te je osim za ciljnu populaciju, kroz prošireni ekonometrijski model, moguće dobiti uvid u kompromise (zamjenu jednog obilježja programa drugim) koji su pripadnici određenih skupina spremni učiniti. Sukladno dobivenim rezultatima istraživanja, može se zaključiti da je potvrđena temeljna hipoteza rada prema kojoj je uvažavanjem preferencija pojedinaca u osmišljavanju i realizaciji zdravstvenih usluga, moguće povećati usvojenost programa od strane pacijenata, odnosno unaprijediti efektivnost javno zdravstvenih preventivnih programa, posljedično i efikasnost sustava javne zdravstvene zaštite. Upravo metode diskretnog odabira (DCE i BWS) pokazale iii su se teorijski opravdane i metodološki primjenjive za vrednovanje preferencija pacijenata,
određenih interesnih skupina kao i šire populacije.
Temeljna svrha doktorske disertacije je objediniti i produbiti spoznaje o važnosti uključivanja izrečenih preferencija i povezanih odabira pojedinaca u proces osmišljavanja, prilagodbe i provedbe preventivnih programa javne zdravstvene zaštite. Slijedom toga, osnovni cilj empirijskog djela ovog istraživanja je, korištenjem ekonomske teorije u svrhu mjerenja i vrednovanja izrečenih preferencija ciljne populacije, utvrditi metodološku i aplikativnu (utvrđivanje relevantnih čimbenika na strani potražnje za zdravstvenim uslugama) važnost i potrebitost vrednovanja izrečenih preferencija prilikom osmišljavanja, provedbe i evaluacije
preventivnih programa javne zdravstvene zaštite, kroz uporabu i usporedbu različitih metoda vrednovanja izrečenih preferencija.Iz navedenih razloga ispitivale su se preferencije žena iz ciljne populacije Nacionalnog programa ranog otkrivanja raka vrata maternice na području Primorsko-goranske županije te utjecaj pojedinih obilježja programa na razinu njihove korisnosti i formiranje odluka o odazivu na screening, koristeći tri različite metode vrednovanje izrečenih preferencija.
Istraživanjem je dokazano (koristeći metodu uvjetovanog ocjenjivanja) kako su različita obilježja Nacionalnog program ranog otkrivanja raka maternice povezana s razinom korisnosti ispitanika. Nadalje, koristeći eksperiment diskretnog odabira (DCE), utvrđeno je da su razine obilježja Programa povezane s odlukama žena o odazivu na screening, dok je metodom najboljeg i najgoreg odabira (BWS), osim promjene u razinama korisnosti unutar pojedinog obilježja (vrijednost skale), utvrđena i razina korisnosti između različitih obilježja Programa, odnosno relativni utjecaj pojedinih obilježja na korisnost ispitanika. Također,
istraživanjem je dokazana i mogućnost usporedbe graničnih korisnosti različitih obilježja prema homogenim grupacijama ispitanika te je osim za ciljnu populaciju, kroz prošireni ekonometrijski model, moguće dobiti uvid u kompromise (zamjenu jednog obilježja programa drugim) koji su pripadnici određenih skupina spremni učiniti. Sukladno dobivenim rezultatima istraživanja, može se zaključiti da je potvrđena temeljna hipoteza rada prema kojoj je uvažavanjem preferencija pojedinaca u osmišljavanju i realizaciji zdravstvenih usluga, moguće povećati usvojenost programa od strane pacijenata, odnosno unaprijediti efektivnost javno zdravstvenih preventivnih programa, posljedično i efikasnost sustava javne zdravstvene zaštite. Upravo metode diskretnog odabira (DCE i BWS) pokazale iii su se teorijski opravdane i metodološki primjenjive za vrednovanje preferencija pacijenata,
određenih interesnih skupina kao i šire populacije.
The purpose of this doctoral thesis is to consolidate and broaden the cognitions on the importance of including stated preferences and related individual choices in designing, adjusting and implementing public health care preventive interventions. Subsequently, the main objective of the empirical investigation was to, based on economic theory, measure and evaluate stated preferences of the target population by using different stated preference valuation methods, in order to identify methodological and applicative relevance of stated preferences valuation in enhancing the effectiveness, and thus the efficiency of public Health care preventive programs.For the above reasons, the analysis of preferences stated by the women in National Program for Early Detection of Cervical Cancer in Primorsko-goranska County, and the impact of
individual program attributes on their utility level and decision to attend screening, was conducted using tree different stated preference methods. The research results achieved by the conditional rating method have proven that different National Program attributes are correlated with the utility level of the respondents. Furthermore, the discrete choice
experiment (DCE) results indicate that different attribute levels impact women’s decisions to attend screening. In addition to determining the changes in the utility levels within individual attributes (i.e. scale value), the best-worst scaling method (BWS) allowed for determining the level of utility between observed National Program attributes i.e. the relative impact of
individual attributes on respondents’ utility. Moreover, the research has confirmed the possibility of comparing marginal utilities of different attributes according to homogeneous groups of respondents, and thus, through the expanded econometric model, allowed insights into compromises (trading one program attribute for another) that the members of certain groups are willing to make. In accordance with the research results, it can be concluded that the basic hypothesis is
confirmed i.e. that by taking into account preferences stated by the target population in the process of the design and realization of health care services, it is possible to increase the attendance rate and improve the effectiveness of the public health preventive programs, and consequently, a more efficient public health care system. It were the methods of discrete
choice (DCE and BWS) that proved to be theoretically justified and methodologically v applicable for the valuation of preferences stated by the specific target population, as well as he broader population.
The paper examines the impact of information technology factors (cloud computing, hardware, software and social media) on supply chain performance and customer satisfaction in the supply chain of the ...world's leading manufacturer of outdoor machinery. Husqvarna AB is the world's leading manufacturer of outdoor machinery and forms a complex supply chain with its partners that includes participants from different continents. Since the management of such a supply chain is extremely complex and multidimensional, the research conducted is useful to gain insight into the current trends in the application of information technology factors and their impact on the effectiveness of the global supply chain. In the Republic of Croatia, a network of sales representatives and service centers has been established, which represent the end points of Husqvarna AB's internal supply chain. The aim of the research is to determine the individual contribution of each factor of information technology and the contribution of supply chain performance to end user satisfaction. After the research, it was found that the hardware and cloud computing factors contribute the most to supply chain performance, while the contribution of software is low. It was also found that the social media factor does not contribute to supply chain performance at all. In the final stage, supply chain performance was found to contribute to customer satisfaction. Based on these findings, this study provides a discussion on the current and future use of information technology in global supply chains.
Jedan je od dugoročnih ciljeva europskih zemalja kvalitetna i pravedna raspodjela zdravstvene zaštite. Pružanje takve zdravstvene usluge dovodi do problema rastuće potrošnje u zdravstvu. Ovaj rad ...ističe da pristup usmjeren na pacijente (PCC), koji je postao nova paradigma za troškovno-efikasno pružanje zdravstvenih usluga, treba postati i nova paradigma u stvaranju zdravstvenih politika i programa. PCC ističe da preferencije, ciljeve i vrijednosti pacijenata treba uvažavati prilikom donošenja odluka u vezi sa zdravljem. Ako se PPC primjeni na problematiku javnog zdravstva, može se reći kako se bilo koji zdravstveni program ili politika trebaju stvarati i evaluirati na temelju preferencija pacijenata. Sukladno s time, cilj je ovog rada elaborirati važnost vrednovanja izrečenih preferencija, kao djela PCC, u procesu donošenja odluka u javnom zdravstvu.
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