Background: The importance of economic evaluation in decision making is growing with increasing budgetary pressures on health systems. Diverse economic evidence is available for a range of ...interventions across national contexts within Europe, but little attention has been given to identifying evidence gaps that, if filled, could contribute to more efficient allocation of resources. One objective of the Research Agenda for Health Economic Evaluation project is to determine the most important methodological evidence gaps for the ten highest burden conditions in the European Union (EU), and to suggest ways of filling these gaps.
Methods: The highest burden conditions in the EU by Disability Adjusted Life Years were determined using the Global Burden of Disease study. Clinical interventions were identified for each condition based on published guidelines, and economic evaluations indexed in MEDLINE were mapped to each intervention. A panel of public health and health economics experts discussed the evidence during a workshop and identified evidence gaps.
Results: The literature analysis contributed to identifying cross-cutting methodological and technical issues, which were considered by the expert panel to derive methodological research priorities.
Conclusions: The panel suggests a research agenda for health economics which incorporates the use of real-world evidence in the assessment of new and existing interventions; increased understanding of cost-effectiveness according to patient characteristics beyond the “-omics” approach to inform both investment and disinvestment decisions; methods for assessment of complex interventions; improved cross-talk between economic evaluations from health and other sectors; early health technology assessment; and standardized, transferable approaches to economic modeling.
Almost all health care services in the Slovenian basic benefits package are paid for from two financial sources: compulsory and complementary health insurance (CHI). Although this is unusual, around ...90% of the population is insured under CHI. CHI covers the costs of copayments for most of the services. One of the advantages of the CHI is that it enables the public sector to shift the costs of service onto the private sector, which can compensate for the higher costs through premiums. Its administrative costs are low, the risk selection is low due to the equalisation schemes in place, and costs of copayments for the socially weak are covered by the state budget. Out-of-pocket costs are low due to most of the population being insured in CHI. On the other hand, there are many disadvantages of this unique amphibian health system. Besides the higher complexity and costs of such a health insurance system, CHI premiums are flat and regressive. The voluntary nature of CHI is highly questionable as the copayments can be as high as 90% of the total service costs. And last, but not least, CHI removes an incentive for the providers and payer to aim for efficient services.
Achieving high quality in the provision of healthcare services represents a basic factor in meeting the healthcare needs of the individuals. Accessibility to health services in Slovenia over the last ...two decades has been presented according to some of the core values of quality and safety: performance, quality and patient-centeredness. The focus of the chapter is on three pillars of health system quality: structure, processes, and outcomes. In each part, we presented the standard practice and state of the art, but also the main achievements in the last decade. In the structural part, we highlight the investment in equipment and human resources and in the process part, the role of the primary level as a gatekeeper with the secondary and tertiary level. The results section concentrates on the measurement of the results in healthcare; the use of quality indicators and PROMs is discussed, the role of quality strategy and health technology assessment in the Slovenian healthcare system is presented.
Članek, ki temelji na raziskavi »Migracije v Sloveniji z luči vključitve v EU«, prikazuje najprej nekatere glavne metodološke utemeljitve, nato sledi prikaz »zaloge« slovenskih emigrantov v tujini in ...tujcev v Sloveniji ter meddržavnih selitvenih tokov v zadnjih dveh desetletjih. Na koncu so prikazane glavne sklepne ugotovitve. Jedro prispevka predstavlja prikaz meddržavnih selitvenih tokov, v okviru katerega prikazujemo tako legalne kot nelegalne tokove. Statistično evidentirani legalni tokovi vključujejo do srede devetdesetih let selitve državljanov, po tem letu pa tudi selitve tujcev. Selitve državljanov predstavljajo majhen delež vseh statistično evidentiranih meddržavnih selitvenih tokov Slovenije. Ne glede na pokritje legalnih meddržavnih selitev je imela Slovenija v zadnjih dveh desetletjihv teh selitvah neto selitveni prirast. Nelegalno priseljevanje je precej obsežnejše od legalnega; v drugi polovici devetdesetih let je slednjega presegalo za 60%.
Following some specification of the sources utilized for statistical data & definition & criteria adopted for the classification of migrational categories, the legal & illegal flows of emigrants & ...foreigners in Slovenia in the 1990s are analyzed & illustrated with statistics pertaining to migration intensity & demographic characteristics, such as age, gender, education, citizenship, regional residence in Slovenia, & destination country. Immigrants & foreign residents are characterized as to country of origin, residence status, political refugee status, & demographics. Data show that by the end of the 1990s, registered emigrants with temporary residence abroad constituted 1.6% of Slovene population, while immigrants, legal & illegal, constituted 2% of the country's residents. External migration of citizens in the second half of the 1990s was only a small part of the total migration flows, & illegal immigration was 60% higher than legal in that period. 15 Tables, 3 Graphs, 22 References. Adapted from the source document.
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