CHANGES IN THE VALUE OF QUALITY INDICATORS IN THE CAPITATION FORMULA FOR PRIMARY HEALTH CARE IN SERBIA DURING THE PANDEMIC
Abstract
Introduction/Aim. The COVID-19 pandemic created new challenges and assignments for primary care, affecting routine health services. This study aimed to measure the changes in the values of the performance indicators that are part of the capitation formula in Serbia using data obtained from the National Health Insurance Fund.
Methods. Data were analyzed at the national level. The indicator change was measured as the absolute difference in the indicator’s values between 2020 and 2019.
Results. In the healthcare services for adults, the values of three indicators related to lifestyle advice increased in 2020 between 3.0% and 3.8%, while the values of indicators related to diabetes, arterial hypertension, and among patients with previous myocardial infarction have decreased in the range of 0.5% to 2.4%. The values of indicators associated with counseling obese children, the adequate number of check-ups of newborns, and services related to early detection and counseling among pregnant women increased by 1.2% to 10.2 %. The other indicators recorded a decline in their value up to 9.9%.
Conclusion. Despite the obstacles faced during the COVID-19 pandemic, primary healthcare has played and continues to play a substantial role in preserving and improving the population’s health.
References
Zhu H, Wei L, Niu P. The novel coronavirus outbreak in Wuhan, China. Glob Health Res Policy. 2020; 5:6. doi:10.1186/s41256-020-00135-6
Stefanovic N, Damnjanović I, Koraćević M, Jovanović A, Catić-Đorđević A, Pavlović D, et al. Pharmaceutical care in community pharmacies during COVID-19 pandemic: Pharmacists experience in Serbia. Acta Medica Medianae. 2024;63(1). doi:10.5633/amm.2024.0102
Atanasijevic D. Analysis of the operation of dialysis centres during the COVID-19 pandemic. Glasnik javnog zdravlja. 2022;96(1):27-38. doi:10.5937/serbjph2201027A
Ivanjac F, Konstantinović V, Miličić B. Impact of the COVID-19 pandemic on dental practice in Serbia-prospective study. Srpski arhiv za celokupno lekarstvo. 2023;151(11-12):640-5. doi:10.2298/SARH230703090I
The first coronavirus case was confirmed in Serbia [press release]. 2020.
Decision on declaring a state of emergency. Official Gazette of the Republic of Serbia No 29/2020-3; 2020.
Karličić I, Đorđević V, Stasevic M, Subotic T, Filipovic Z, Ignjatovi Ristic D, et al. Perspectives on mental health services during the COVID-19 epidemic in Serbia. Srpski arhiv za celokupno lekarstvo. 2020;148(5-6):379-82. doi:10.2298/SARH200504028S
Office of the United Nations High Commissioner for Human Rights. Impact of the COVID-19 on vulnerable groups and groups at risk causes, outcomes and recommendations. Belgrade (Serbia)2020.
Zakon o zdravstvenoj zastiti [Translated Title: Health Care Law]. Official Gazette of the Republic of Serbia No 25/2019; 2019.
World Health Organization. Regional Office for Europe, European Observatory on Health Systems and Policies, Bjegovic-Mikanovic V, Vasic M, Vukovic D, Jankovic J, et al. Serbia: Health system review: World Health Organization. Regional Office for Europe; 2019.
Pravilnik o ugovaranju zdravstvene zaštite iz obaveznog zdravstvenog osiguranja sa davaocima zdravstvenih usluga za 2019. godinu [Translated Title: Rulebook on contracting health care from compulsory health insurance with health care providers for 2019]. Official Gazette of the Republic of Serbia No 106/2018-34 2018.
Majeed A, Maile EJ, Bindman AB. The primary care response to COVID-19 in England's National Health Service. J R Soc Med. 2020;113(6):208-10. doi:10.1177/0141076820931452
National Health Insurance Fund. Kapitacija [Translated Title: Capitation] 2021 [Available from: https://www.batut.org.rs/download/zdravstveni_pokazatelji_rs_2020.html.
Coma E, Mora N, Mendez L, Benitez M, Hermosilla E, Fabregas M, et al. Primary care in the time of COVID-19: monitoring the effect of the pandemic and the lockdown measures on 34 quality of care indicators calculated for 288 primary care practices covering about 6 million people in Catalonia. BMC Fam Pract. 2020;21(1):208. doi:10.1186/s12875-020-01278-8
Rachamin Y, Senn O, Streit S, Dubois J, Deml MJ, Jungo KT. Impact of the COVID-19 Pandemic on the Intensity of Health Services Use in General Practice: A Retrospective Cohort Study. Int J Public Health. 2021; 66:635508. doi:10.3389/ijph.2021.635508
Institute of Public Health of Serbia „Dr Milan Jovanovic Batut”. Odabrani zdravstveni pokazatelji 2019 (Translated Title: Selected health indicators for 2019). Belgrade, Republic of Serbia2020.
Institute of Public Health of Serbia „Dr Milan Jovanovic Batut”. Zdravstveni pokazatelji u Republici Srbiji – sistem prezentacije podataka [Translated Title: Health indicators in the Republic of Serbia - data presentation system] 2021 [Available from: https://www.batut.org.rs/download/zdravstveni_pokazatelji_rs_2020.html.
Institute of Public Health of Serbia „Dr Milan Jovanovic Batut”. Health Statistical Yearbook of Republic of Serbia 2019. Belgrade, Republic of Serbia2020.
Institute of Public Health of Serbia „Dr Milan Jovanovic Batut”. Health Statistical Yearbook of Republic of Serbia 2020. Belgrade, Republic of Serbia2021.
Mitricevic S, Jankovic J, Stamenkovic Z, Bjegovic-Mikanovic V, Savic M, Stanisavljevic D, et al. Factors Influencing Utilization of Preventive Health Services in Primary Health Care in the Republic of Serbia. Int J Environ Res Public Health. 2021;18(6). doi:10.3390/ijerph18063042
Soares P, Leite A, Esteves S, Gama A, Laires PA, Moniz M, et al. Factors Associated with the Patient's Decision to Avoid Healthcare during the COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18(24). doi:10.3390/ijerph182413239
Uredba o nacionalnom programu zdravstvene zaštite žena, dece i omladine [Translated Title: Decree on the National Health Care Program for Women, Children and Youth]. Official Gazette of the Republic of Serbia No 28/2009; 2009.
Allen T, Mason T, Whittaker W. Impacts of pay for performance on the quality of primary care. Risk Manag Health Policy. 2014; 7:113-20. doi:10.2147/RMHP.S46423
What Is Pay for Performance in Healthcare? Catalyst Carryover. 2018;4(2). doi:10.1056/CAT.18.0245
Lezzoni LI. Assessing quality using administrative data. Ann Intern Med. 1997;127(8 Pt 2):666-74. doi:10.7326/0003-4819-127-8_part_2-199710151-00048