Public and Private Healthcare in Slovenia in Relation to Choice and Accessibility of Services

Public and Private Healthcare in Slovenia in Relation to Choice and Accessibility of Services

Matic Kavčič (Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia) and Majda Pahor (Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia)
DOI: 10.4018/ijpphme.2013070101
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Abstract

This article starts with background information on the Slovenian healthcare system and the description of the evolutionary process and privatisation reforms that bring a mix of public and private healthcare services. The authors' aim is to conceptualise existing modes of public and private healthcare provision and discuss possible implications for user choice and accessibility of services. A descriptive and exploratory case study approach was employed. Literature and document analysis was complemented by secondary data and semi-structured interviews. The results demonstrate four modes of healthcare services in relation to public-private delivery. The ‘public non-profit' type refers to publicly financed and delivered services. The ‘private within public' type addresses services provided within and by the public sector for patients who pay out-of-pocket. The ‘private for public' type deals with services provided by private entities with concessions. The ‘private for-profit' type refers to completely private provision (without concession) of self-pay services. The strengths and weaknesses of each mode with respect to choice, space-time accessibility, financial accessibility and quality of services are critically discussed. The results of the study show that private healthcare services significantly complement and compete with public sector. In addition, there is a risk that uncontrolled mixing of public and private modes of practice may bring about unethical behaviour and corruption.
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Background: Slovenian Healthcare System And The Process Of Privatisation

In Slovenia, we can historically trace the beginnings of social insurance back to the end of the 19th century, when it was a part of the Austro-Hungarian Empire. The first health insurance to cover the illnesses of workers was established in 1858, and compulsory insurance to cover injury was added in 1887. Regarding more recent times, in the 1970s, legal developments brought about equal insurance for the entire population (Albreht et al., 2009). On the other hand, Slovenia had a long history with private practice as well. According to Albreht and Klazinga (2009), it existed from the beginning of the organised medical profession in the 19th century and remained a key provider until the development of primary healthcare centres that were established between the world wars. Not long after World War 2, private practice was abolished. However, some services remained on the ‘grey market’ (Albreht & Klazinga, 2009).

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