The study assessed the present response of Serbia health care system to increasing trends in morbidity rates caused by malignant neoplasms. The objective was to identify the key shortcomings and to propose feasible solutions for overcoming them. Authors reviewed the latest epidemiology data, health care expenditures and evaluated the current normative and organization of health care delivery. Economics Institute organized two Forums, with the leading oncology specialists and state authorities. Conclusions from these discussions gave a valid contribution and are incorporated in the study.
Epidemiology data show that incidence of malignant neoplasms in Serbia is close to majority of European countries, however survival rates lack behind the EU average, consequently mortality rates are among the highest in Europe. The reasons beyond this are double fold; (1 the country did not earmarked sufficient resources for fighting cancer and (2) organization of health care services is outdated and fragmental with the high spatial inequity and over-involvement of the tertiary care. Financing of health care has been affected by the economic crisis, since 2008 the state Health Insurance Fund’s income has been decreasing steadily, on average by 4% points annually. Lack of resources brought uneven supply of pharmaceuticals, causing delay in therapies, while patients are deprived of possibilities to be treated with the more advanced protocols. Delivery of health care is affected by the shortages of health care specialists; caused by the absence of staff planning and shortfalls in the education system. In such environment, the major burden is shifted on the tertiary institutions, which perform basic services which could be delivered at the secondary care level.
Key recommendations point to the necessity of urgent response of the state authorities. The viable solution could be reached only by the active involvement of practicing professionals, patients groups and national professional bodies.