Juraj Nemec, Marek Pavlík, Ivan Malý and Zuzana Kotherová
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The aim of this study was to explore citizens' expectations about local health policies in order to create an adequate strategy. Local authorities in many countries place health in the core of their strategic planning aiming to create and improve a health-supporting social and physical environment, as they usually have primary responsibility for planning and/or delivering many of the services that are crucial to addressing the social determinants of health. Local health policies are created in consultation with local health services, NGOs and citizens. The survey was conducted among 400 citizens of Pleven Municipality. Of these, 335 (83.75%) responded to the invitation. Information on health problems and determinants of health was collected through a direct inquiry survey. The majority of citizens considered the impact of environmental, educational, cultural and economic factors as well as public security on their health. They expected that more purposeful efforts of the local authorities be directed for improving living conditions and inequalities in health. The citizens are willing to work together with municipalities to create health policies, which reduce negative factors and increase positive ones. They are aware that local policies and decisions have a very significant impact on the economic, social and environmental factors affecting health and well-being and therefore municipalities play a key role in improving and protecting the health of their citizens.
Karolína Dobiášová, Eva Tušková, Pavla Hanušová, Olga Angelovská and Monika Ježková
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Justin Laureano, Ferman Konukman, Hayrettin Gümüşdağ, Şamil Erdoğan, Jong-Hoon Yu and Resul Çekin
healthpolicies and program study 2006. Journal of School Health, 77(8), 567-587.
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Policy Interventions to Tackle Health Inequities in Macedonia: Patient Rights and Reference Pricing of Pharmaceuticals
Background. Health inequities refer to differences in the health status among the various groups of the population caused by modifiable external conditions and environment created in and around the health care system. The Government of Republic of Macedonia has adopted law of patient's rights and implemented referent pricing of the pharmaceuticals with primary purpose to deal with inequities in health care.
Aim. The aim of this paper is to present the challenges in implementation of two health policy interventions developed to reduce health inequities in Macedonia.
Methods. The study is descriptive analysis of two health policy interventions. The interventions selected for analysis were most popular health policies widely promoted by the Government. The paper reviews the process, adoption of the laws and implementation of the interventions. The initial impact of the interventions is assessed over media reports, responses of the medical community, patients and is compared to international experiences.
Results. Available information show that implementation of the law of patients rights has not achieved its primarily purpose, yet. The reference pricing has shifted the burden for financing of the pharmaceuticals from the Health insurance fund, to the patients.
Conclusions. More specific studies needs to be designed to assess the impact of these policies on the equity in the health care system in Macedonia.
This paper focuses on the methods to reduce social inequalities through appropriate public health management implemented within the EU. In the initiatives taken by the EU, it is important to contribute to the achievement of greater equality in terms of health in all social groups in the member states, and to reduce heterogeneity between countries in combating health inequalities by focusing on their socioeconomic determinants related to health and lifestyles. The research method adopted in this paper was the analysis of documents related to direct actions on health safety and health policy within the European Union.
Igor Spiroski, Dragan Gjorgjev, Jasna Milosevic, Vladimir Kendrovski, Daniela Naunova-Spiroska and Dominique Barjolle
Background: The objective of our study was to explore the knowledge, attitudes and practices of Macedonian consumers towards functional foods, to predict future trends and to assess the national public health policies encompassing the functional foods market.
Methods: Total of 518 respondents aged 18+, from all regions in the country participated in the study. They were sampled through three-staged national representative sampling procedures. The questionnaire comprised questions regarding the level of information about functional foods, trust in health claims, frequency of consumption and knowledge and attitudes related to those foods. Statistical significance was determined at p<0.05.
Results: Respondents aged 18-34 were more informed compared to the total population (22 and 16 % respectively, p<0.05). Most of the consumers consume these products once a day. Employed consumers were willing to increase daily consumption from 3 to 18 % (p<0.05). On average 65.1% of the statements assessing knowledge were answered correctly. On a scale from -3 to +3 functional foods were considered as very healthy (mean=2.03, SD=1.42).
Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products.
This paper analyses the impact of the financing arrangements for planned cross-border health care within the European Union. A financial arrangement is taken to provide a financial incentive but may also involve payment risks and administrative burden. For the pathways given by the Social Security Regulations (883/2004 and 987/2009) and the EU Directive 2011/24/EU, we investigate how the associated financial arrangements act on providers, patients and on publicly funded health insurance. First, the Regulations can induce cross-border health care that will increase domestic health care expenditure and may threaten national health policy by setting an incentive for patients to go abroad for health care not covered by domestic health insurance. Second, the financial arrangement of the Directive may induce cross-border health care which will lower domestic health care expenditure. However, due to considerable payment risks and administrative burden on both patients and providers, these benefits will not be reaped in full. Moreover, in the presence of national cost containment policies, the Directive may provide an incentive for cross-border health care that is too strong. Finally, due to the requirement to pay upfront, the financial arrangement also suffers from a lack of equity of access to health care provision abroad.
Nela Djonovic, Ivana Simic Vukomanovic and Dalibor Stajic
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