Author/Editor     Albreht, Tit; Delnoij, Diana M J; Klazinga, Niek
Title     Changes in primary health care centres over the transition period in Slovenia
Type     članek
Source     Eur J Public Health
Vol. and No.     Letnik 16, št. 3
Publication year     2006
Volume     str. 237-42
Language     eng
Abstract     Background: Primary health care centres (PHCCs) were a characteristic of the former Yugaslav health care system introduced widely in Slovenia. Transition brought structural changes to health care and the position of the PHCC's was challenged. This paper investigates (i) PHCCs' perception of transition changes in health care, (ii) changes in resources and services, and (iii) changes in the relationships betweern PHCCs and new primary health care providers. Methods: We mailed a self-administered questionnaire with 42 questians divided into 8 chapters and related to the period between 1990 and 2000 to all 65 PHCCs in Slovenia. Questions were of three types, grouped accarding to the aspects we were trying to explore: perceived changes, actual changes and relations with new providers. Results: We obtained 57 questionnaires representing PHCC catchment areas covering 93.7% of the Slovenian population. Municipalities' position versus PHCCs was reinforced but their role remains ambiguaus. The number of employees was reduced by one third, capital investments are still ongoing, but the scope and volume of services has shrunk. Relations with the Health Insurance Institute of Slovenia (HIIS) were considered controversial while the influence of the public providers' association is perceived as marginal. Conclusions: PHCCs have survived the transition both structurally as well as functionally. However, an unstructured approach to system changes in primary care, a poorly managed process of introducing private provision, and a monopoly position of the HIIS affected their situation. The challenges for the future will be in preserving their public health functions, in increasing efficiency and in establishing clearly defined relations with private providers.
Descriptors     PRIMARY HEALTH CARE
PUBLIC HEALTH
PRIVATE PRACTICE
HEALTH CARE REFORM
QUESTIONNAIRES