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Mariela Busic - Croatia - Monday 28 - Financing the Donation and Transplantation Process
1. The Financing model in Croatia and South East European countries Mirela Bušić, MD National transplant coordinator, Croatia
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3. The Balkan peninsula The term Balkan is painted in a negative meaning: violence, religious and ethnic intolerance, the overall backwardness, corruption and division. So this word is being avoid on the border areas and often is considered derogatory
9. Demographic indicators of SEE Region (Source: www.who.int and national reports) Member 101 2053014 20273 SLOVENIA Candidate 10,8 ~68,7 49,95 50,05 59,5 40,5 79,54 2 045 262 25 713 MACEDONIA SAA 12,1 ~67,2 49,8 50,2 62 38 44,89 620 145 13 812 MONTENEGRO SAA NA NA NA NA 51,58 48,42 96,78 7 498 000 77 474 SERBIA Memeber 14,5 61,3 48,8 51,2 53,3 46,7 90,87 21 673 328 238 500 ROMANIA - ~13,6 ~62,5 48 52 41,4 58,6 106,71 3 606 800 33 800 MOLDOVA Candidate median age: 39,97y 48 52 58 42 78,48 4 437 460 56 542 CROATIA Memeber 17 NA 48,6 51,4 69,4 30,60 70,68 7 845 841 111 000 BULGARIA SAA 12,16 62,79 48,85 51,15 43,9 ~56,0 76,15 3 828 397 51 209 BIH SAA 7,52 53,56 49,8 50,2 44,5 55,5 109,12 3 126 153 28 648 ALBANIA >65y 20–64y Male % Female % EU status Age (%) Gender Urban % Rural % Density People /sq km Population Size (Sq km) Country
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11. Economic indicators of SEE region (2008) (Source: www.who.int) - 2877,46 9,01 36 663,1 EU - 1968,94 7,56 25 512,6 EUROPE 0,849 3836 10,1 49 739,1 AUSTRIA 0,828 2183 7,8 26 910,7 SLOVENIA 0,695 702 7 4 662,52 MACEDONIA 0,771 1319 9,5 7 262,43 MONTENEGRO 0,733 838 9,8 6 646,96 SERBIA 0,765 665 4,7 9 299,74 ROMANIA 0,622 318 10,7 1 695,97 MOLDOVA 0,766 1496 7,8 15 636,60 CROATIA 0,741 910 7,3 6 798,13 BULGARIA 0,71 867 10,3 4 906,18 BOSNIA AND HERZEGOVINA 0,713 543 6,9 4125,82 ALBANIA Human Development Index (HDI) Total health expenditure, PPP$ per capita Total health expenditure as % of GDP GDP US$ per capita COUNTRY
20. Structure of organ donation and transplantation system in SEE countries 2010 E – establishing under way NTO – nationa ltransplant organisation OPO – organ procurement organisation NTC – national transplant coordinator Yes Yes Yes Yes Yes NA Yes Yes SLOVENIA No E No NA No No No E MACEDONIA No E No No No No E E MONTENEGRO No Yes Y es Yes No No E Yes SERBIA No Yes Y es Yes Yes yes Yes Yes ROMANIA No Yes No Yes Yes No Yes Yes MOLDOVA Yes Yes Y es Yes Yes NA Yes Yes CROATIA No Yes Y es Yes Yes NA Yes No BULGARIA No No No Yes Yes No No No BIH RS No No Yes * No No No No No BIH F No No No No No No No No ALBANIA ET member NTC Deceased donation program Allocation rule In-house coordinator OPO NTO Competent Authority Country
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24. Financing Organ donation and transplantation in Croatia Source: Croatian Institute for Health Insurance report
25. CROATIA: Hospital reimbursement for donor management cost (by Croatian Health Insurance Institute) Source: Croatian Institute for Health Insurance report
26. Transplantation cost in Croatia Reimbursement to tx centers by Health Insurance Institute Source: Croatian Institute for Health Insurance report
27. Volume and utilization of the additional funds Croatian MoH budget Source: Goverment budget - Mohsw
28. Conclusion Comparing the available data regarding the current financing mechanisms for the tx system, different models are present; some proven to be optimal (such as Croatian and Slovenian), some limited, and some with no financial support. This last can be explained with the fact that not all of the Ministries of Health have acknowledged organ transplantation as a priority in the public health field, mainly due to the very low economic indicators and health care expanditure available.
