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Authors: Besa Shahini
Keywords: health economics, public-private partnership, nonparamtric methods, healthcare reform
Abstract: The debate on health system reform has established great interest among policymakers and the of researchers’ community throughout the world, especially during the last few decades. We all are interested in finding effective instruments to improve health system performance and also want to learn what are the best systems, in order to reform our own country's health system. Albania's health system is the result of considerable development and transformation in years, followed by significant changes in terms of organization, management, and financing. Currently, the system of health financing in the Balkans and specifically in Albania, is a mix between public and private. The aim of the study is to verify if it is of Albania’s interest to continue following the model of financing health insurance scheme based on contributions for health insurance, supported by the income of the state budget for inactive persons while strengthening control mechanisms and co-payments or it is the proper moment for the country to apply a new financing scheme on health system? Following this goal, the study was conducted in the framework of a mix research methodology. The study is carried out following the normal structure of a research, i.e. : Financing Healthcare System in the Balkans, Reforms of the health system in Albania, The theoretical framework, data and descriptive statistics; and Empirical findings and results. Three types of questionnaires were conducted; 1- Referring to the patients of primary and hospitals’ services, 2- Referring to primary services’ doctors, 3- Referring to the hospitals’ doctors. Quantitative and qualitative questions of these questionnaires are designed to measure the perception of health service stakeholders on the performance of this sector, while through the providers and beneficiaries of health services’ point of view. There are used nonparametric methods to study the dependence of the variables arising from the questions of the questionnaire and it has been established a regression analysis to understand the linkage among financial contributions collected for health insurance (Y) and 3 independent variables of the health insurance scheme i.e.: the number of insured people (X1), the number of Physicians (X2), the number of reimbursed medicines (X3). The regression analysis helps to better understand if and how much the 3 independent variables affect the growth of revenues from contributions to the Health Insurance Scheme. The findings, which results from a detailed analysis of the participants’ number in the insurance scheme years, and of the factors that influence the system of contributions in Albania (macroeconomic, social and political), do stress the idea of an increasing health insurance contribution amount (the cast was set for the first time in 2006 by the World Bank and supported but not finalized by the Institute of Health Insurance). The empirical results conclude that the English model of general taxation can’t well be performed in Albania, so the country should continue to follow the mix- funding model on health insurance contribution scheme, i.e. the one financed partly by the budget state and partly by individual contribution.