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WORLD BANK TECHNICAL PAPER NO. 348
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(List continues on the inside back cover)
WORLD BANK TECHNICAL PAPER NO. 348
Soial Challenges of Transition Series
Trends in Health Status,Services, and Finance
The Transition in Central andEastern EuropeVolume II, StatisticalAnnex
Gnanaraj ChellarajOlusoji AdeyiAlexander S. PrekerEllen Goldstein
The World BankWashington, D.C.
Copyright © 1996The International Bank for Reconstructionand Development/THE WORLD BANK1818 H Street, N.W.Washington, D.C. 20433, U.S.A.
All rights reservedManufactured in the United States of AmericaFirst printing December 1996
Technical Papers are published to communicate the results of the Bank's work to the development communitywith the least possible delay. The typescript of this paper therefore has not been prepared in accordancewith the procedures appropriate to formal printed texts, and the World Bank accepts no responsibility forerrors. Some sources cited in this paper may be informal documents that are not readily available.
The findings, interpretations, and conclusions expressed in this paper are entirely those of theauthor(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, orto members of its Board of Executive Directors or the countries they represent. The World Bank does notguarantee the accuracy of the data included in this publication and accepts no responsibility whatsoeverfor any consequence of their use. The boundaries, colors, denominations, and other information shown onany map in this volume do not imply.on the part of the World Bank Group any judgment on the legal status of anyterritory or the endorsement or acceptance of such boundaries.
The material in this publication is copyrighted. Requests for permission to reproduce portions of itshould be sent to the Office of the Publisher at the address shown in the copyright notice above. TheWorld Bank encourages dissemination of its work and will normally give permission promptly and, whenthe reproduction is for noncommercial purposes, without asking a fee. Permission to copy portions forclassroom use is granted through the Copyright Clearance Center, Inc., Suite 910, 222 Rosewood Drive,Danvers, Massachusetts 01923, U.S.A.
'For a copy of Update describing new publications, contact the Distribution Unit, Office of the Publisher,The World Bank, 1818 H Street, N.W., Washington, D.C. 20433, U.S.A., or Publications, The World Bank,66, avenue d'Iena, 75116 Paris, France. A catalog and ordering information are also available on theInternet at http://www.worldbank.org.
All of the authors work for the World Bank. Gnanaraj Chellaraj is a consultant to the Bank. OlusojiAdeyi is a health specialist in the Human Resources Operations Division of the Europe and Central AsiaDepartment. Alexander S. Preker is senior health economist in the Human Development Department. Atthe time of writing, Ellen Goldstein was senior human resources economist in the Human ResourcesOperations Division of the Europe and Central Asia Department.
ISSN: 0253-7494
Cover montage by Joyce C. PetruzzelliPhotos by Nelson Ryland.
Library of Congress Cataloging-in-Publication Data
Trends in health status, services, and finance: the transition inCentral and Eastern Europe / Ellen Goldstein ... [et al.].
p. cm. - (World Bank technical paper, ISSN 0253-7494 ; no.341. Social challenges of transition series)
Includes bibliographical references.Contents: v. 1. [without special title] - v. 2. Statistical annex.ISBN 0-8213-3751-3 (v. 1) - ISBN 0-8213-3828-5 (v. 2)1. Medical care-Europe, Eastem. 2. Medical care-Europe,
Central. 3. Health status indicators-Europe, Eastern. 4. Healthstatus indicators-Europe, Central. 5. Medical care-Europe,Eastern-Finance. 6. Medical care-Europe, Central-Finance.I. Goldstein, Ellen, 1960- . II. Series: World Bank technicalpaper ; no. 341. III. Series: World Bank technical paper. Socialchallenges of transition series.RA407.5.E852T74 1996 96-40968362.1'0943-dc2O CIP
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TABLE OF CONTENTS
FOREWORD .............. v
ACKNOWLEDGMENTS ............................ vii
ABSTRACT ............... ix
INTRODUCTION ............................. xi
LIST OF ACRONYMS ............................. xiii
CHAPTER I: Data Sources and Limitations .............................. 1
CHAPTER II: Statistical Templates ............................. 7
CHAPTER III: Figures ............................ 101
GLLOSSARY ............................ 129
BIBLIOGRAPHY .......... 131
FOREWORD
Transition from central planning in Central and Eastern Europe has led to dramatic and rapidchanges in the lives of millions of people. Democratic liberalization has empowered citizens through theprovision of basic rights and freedoms and the development of civil society, while economic liberalizationhas brought the promise of improved living standards, and granted individuals increased choice inconsumption, education, health and employment.
Despite remarkable expansion of opportunity, transformation has not come without great pain.Poverty has risen throughout the region, real incomes have declined, and crude death rates have climbed inmany countries. Equality among households has suffered as a result of increasing income disparity and theerosion of access to basic social services. While the widening income gap is an expected side effect oftransition, accompanying the liberalization of prices and wages, heightened social dissatisfaction threatenspolitical stability and the success of economic reforms.
On the most basic level, economic recovery and growth in transition depend upon the capacity ofindividuals to respond and adapt to the changing requirements of market society. The socialist economiesembarked upon reform with strong legacies of state commitment to the development of human capital.However, rigidities of central planning and bureaucratic control limited the quality and efficiency of socialservices. Transition has exacerbated these trends, as unprecedented collapses in output and consequentfiscal crises have undermined the abilities of governments to sustain pre-transition levels of access to socialprograms and services. At the same time, the introduction of market forces has opened up an array ofopportunities for innovation in the provision and financing of health, education and social insurance, and foraddressing increases in poverty and unemployment.
This paper is one in a series of reports based upon the Social Challenges of Transition (SCT)database. Developed by the Human Resources Operations Division of the Central and Southern EuropeDepartments of the World Bank, SCT was initiated in order to document empirically the evolving effects oftransition on individuals and families. The project examines the social risks facing people and the policyresponses taken by governments since 1989, by monitoring indicators of health, earnings, education, labormarkets, pensions, social assistance and poverty. The findings contained in this initial set of thematic cross-country papers make a valuable contribution to our understanding of social developments in Central andEastern Europe five years into the transition. They provide a basis for further improvements in the contentand quality of our support to the countries in the region.
Kenneth G. Lay Jean-Michel SeverinoDirector DirectorCountry Department I Country Department IIEurope and Central Asia Region Europe and Central Asia Region
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ACKNOWLEDGMENTS
The material reported in this paper was prepared as a part of a larger, multi-sectoral study on theSocial Challenges of the Transition in the Central and Eastern Europe, undertaken by the World Bank'sHuman Resources Operations Division, Central and Southern Europe Departments under the direction ofRalph W. Harbison, Human Resources Division Chief for Central and Southern Europe (EC1/2HR).
Much of this study would not have been possible without the close collaboration of the EuropeanOffice of the World Health Organization in Copenhagen and its Health For All (BFA) monitoringnetwork throughout Central and Eastern Europe. The authors are particularly indebted to Mr. NandaArun (European Regional Office of the World Health Organization in Copenhagen) and Dr. Jean-PierrePoullier (OECD) for their early contributions to the methodological design of the study. Invaluablecooperation and contributions, especially the time-consuming process of compiling the data, werereceived from the staff of the Ministries of Health, Ministries of Finance, Ceniial Statistical Offices andother counterpart agencies throughout Central and Eastern Europe.
The authors would also like to thank Mr. Kemal Dervis (Vice President, MNA Region) and Mr.Andrew Rogerson (Director of Africa 3 Department) for their continued enthusiasm and support duringthe early phases of the study. Peer reviewers, Mr. George Schieber and Dr. Prabhat Jha (HumanDevelopment Department), Dr. Jose-Luis Bobadilla (Principal Health Specialis( Inter-AmericanDevelopment Bank), Dr. David Peters (West Central Africa Department) and Dr. ,Martin McKee (SeniorLecturer, London School of Hygiene and Tropical Medicine) provided valuable comments during thefinal revision of the document. Ms. Dena Ringold (Research Assistant) and Mr. Brandon Cline (StaffAssistant) made substantial editorial improvements to the text. Technical support for the SCT datacollection exercise was provided by Mr. Jan Rutkowski and Ms. Dorota Holzer (Consultants, WorldBank Resident Mission Warsaw), Stephen Heyneman and Verdon Staines, (EMTHR) who providedtechnical and partial financial support for the study, and Mr. Ross Pavis (Staff Assistant, EC1/2HR).
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ABSTRACT
This paper is the Statistical Annex to the report, "Trends in Health Status, Services and Finance:The Transition in Central and Eastern Europe," and is part of a cross-national study of trends in healthand health care during economic transition to a market economy. It describes the data analyzed in themain report, and contains comprehensive charts and tables of epidemiological, demographic and healthfinancing indicators for the period 1987-1995. The annex also describes the data sources and discussesdata quality. As is the case in many developing countries, information on health, health care andfinancing in the transition economies has been scarce and unreliable. The quality and comparability ofmuch of the data obtained for this study is limited by changes in collection methodologies, discrepanciesin definitions, and outdated information technologies and accounting systems. This study makes a usefulcontribution to an understanding of the impact of transition on the health sector in Central and EasternEurope, and highlights the need for a more systematic approach to data collection and operationalresearch in the region, supported by the World Bank and the various intemational agencies.
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INTRODUCTION
Lack of information on demographic, epidemiological and health financing indicators has been apersistent problem in developing countries. Many developing countries lack detailed breakdowns ofhealth status and service data, and data on private services and expenditures are almost non-existent. Ata time when declines in GDP have resulted in increasing poverty (World Bank, 1995, 1996) and reducedaccess to basic health care needs (Preker and Feachem, 1996), the availability of health related data isvital for identifying critical issues in health at the country and regional level. Furthermore,comprehensive data are essential for the development of viable health care projects and policies (Segall,1991; Hammer, 1996). This paper is the Statistical Annex to the main report, "Trends in Health Status,Services and Finance: The Transition in Central and Eastern Europe, Volume I." It contains the dataanalyzed in the report as well as charts on epidemiological, demographic and health financing indicatorsfor the period 1987-1995. It represents part of the Social Challenges of Transition (SCT) project, abroader effort by the World Bank to compile and analyze social sector data in Central and East Europe(CEE).
Relative to the established market economies (EME), the availability of health expenditure datain developing countries is poor. Abel-Smith standardized cross-national data by defining categories ofhealth services, listing the sources of finance for the countries of Western Europe and North America(Abel Smith, 1963, 1967). During the past two decades several studies have been undertaken mostly inindustrialized countries, regarding the trends in health expenditures (Schieber and Poullier, 1993, 1991a,1991b, 1987; Schieber, 1990, 1987; Newhouse, 1987; 1977; Parkin et al., 1987; McGuire et al., 1996;Hitiris and Posnett, 1992; Murillo et aL., 1993; Gerdtham et al., 1992; Gerdtham and Jonsson, 1994;1992; 1991; Pfaff, 1990; Culyer, 1988; Wolfe, 1986). In addition, methodologies for tracking andcomparing both public and private health care expenditures in industrialized countries have also beendeveloped (Getzen and Poullier, 1991; Poullier, 1989; Getzen, 1990; OECD 1985, 1989).
The World Development Report (WDR) 1993 was one of the first comprehensive attempts togather health-related data across developing countries and transition economies. Since the early 1990s,several attempts have been made to gather and analyze health-related data across regions such as LatinAmerica (McGreevey, 1992; Lee and Bobadilla, 1994; Govindaraj et al., 1995, 1996; Musgrove, 1983),Africa (Vogel, 1992; 1989; Gbesemete and Gerdtham, 1992) and Asia (Griffin, 1992), and in individualcountries such as Barbados (Chellaraj, 1992), Mexico (Chellaraj, 1994), Hong Kong (Chu, 1994), IvoryCoast and Peru (Gertler and van der Gaag, 1990), Egypt (Rannan-Eliya, 1995), Sri Lanka (Rannan-Eliya,1996), Zambia (Berman et al., 1995) and South Africa (McIntyre, 1995), as well as data on internationalassistance (Michaud and Murray, 1993). However, the data collected during most of these studies wererather limited in scope, and detailed breakdowns of health expenditures were rarely presented. TheWorld Bank is currently developing a methodology for National Health Accounting schemes indeveloping countries (World Bank, 1996) which will facilitate the collection and analysis of healthrelated data.
For Central and Eastern Europe, the only available data on health expenditures were empiricalestimates based on the statistical model developed for the 1993 WDR (Murray et al., 1993, 1994), whilethe 1996 WDR addresses additional health related issues in the former socialist economies (FSE).Furthermore, the 1993 WDR model forecast only total expenditures for individual countries as a whole,and did not provide information on categories of expenditures including wages and drugs, or on levels ofservices such as public health, or personal health services such as hospitals and polyclinics. Finally, therelationship between epidemiological and demographic indicators and trends in health expenditures wasnot analyzed in most of the studies discussed above. In an attempt to address these drawbacks in the
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Central Asian transition economies, a detailed analysis was recently undertaken on health expenditures inCentral Asia, which took into consideration the health status of the population and delivery of healthservices (Klugman et al., 1996). The present study is an improvement over the previous attempts, as itcompiles detailed data on health expenditures by categories and levels such as personal health services,and demographic, epidemiological and health service delivery indicators in selected CEE countries.
This Annex is structured as follows: Chapter I provides a brief review of data sources, and theproblems associated with data availability and the existing accounting systems and MIS in individualcountries; Chapter II presents and discusses the statistical templates; Chapter III presents the variousfigures and charts (these are discussed in the main report, Volume I, to which the reader is referred); andChapter IV is a glossary which provides the definitions of the terms used in the report.
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LIST OF ACRONYMS
CEE Central and Eastern Europe.
EME Established market economies.
FSE Former socialist economies.
FYR Former Yugoslav Republic.
GDP Gross Domestic Product.
GHIC General Health Insurance Company.
HFA Health For All (database maintained by the WHO).
IMF International Monetary Fund.
IMR Infant Mortality Rate.
MIS Management Information System.
MOF Ministry of Finance.
MOH Ministry of Health.
MOL Ministry of Labor.
NHI National Health Insurance Fund.
NIA National Income Accounts.
OECD Organization for Economic Cooperation and Development.
SDR Standardized Death Rate.
UNDP United Nations Development Program.
WDR World Development Report.
WHO World Health Organization.
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CHAPTER I: DATA SOURCES AND LIMITATIONS
Data Sources
Data for this study were collected from both primary and secondary sources, based on astandardized template. The health status module included well-known indicators of life expectancy,mortality, morbidity, natality and fertility, as well as data on nutrition, sanitation and lifestyle behaviors.The health services module focused on health personnel, infrastructure, utilization rates, quality of care,public health activities, privatization and private sector development. These two sets of indicators werebased on standard definitions, used internationally by the World Health Organization (WHO). Thehealth finance module outlined sources of funds (e.g. central budget, national health insurance,households) from both the public and private sectors. Uses of funds were examined according to broadexpenditure categories (e.g. personnel expenditures, drug expenditures, utilities) and level of health care.The latter module also sought information on average salaries for health personnel. In designing thehealth finance module, reference was made to the Organization for Economic Cooperation andDevelopment's (OECD) Resource Accounting System, which includes a standardized health finance andexpenditure database for its 24 OECD member countries. Efforts were made to ensure consistency indefinitions and comparability of data with the OECD database, although the disaggregated data set wasmuch more limited.
Much of the data on health status, and a portion of the data on health services, were obtainedfrom the WHO Health for All (HFA) database for Europe region, which includes Western Europe as wellas Central and Eastern Europe and the countries of the former Soviet Union. The HFA database,consisting of approximately 270 health indicators in the European region, was initiated in 1985 to trackinternational progress in meeting the targets of Health for All by the Year 2000.1 For countries in arrearson their reporting, or for those with no past reporting to the WHO (e.g. the independent countries of theformer Yugoslav federation), the authors worked with ministries of health and national statistical officesin the field to gather the data needed to complete the time series, according to standard WHO definitions.More recent data on life expectancy and age-standardized death rates were obtained from the WorldHealth Statistics Annual for 1993 and 1994.2 3
Collecting data on the sources and uses of funds and average wages for the health financemodule required extensive field work, and often involved laborious reclassification and/or aggregation ofdata to ensure cross-national comparability. The problem was aggravated by the lack of up-to-dateManagement Information Systems (MIS) and accounting systems in a number of countries. In somecases, data requested w-re hand-written by government officials due to the lack of computers and othertechnological know-how. Most data were collected directly from Ministries of Finance (MOF) and/ornational health insurance offices. The only exception was in the former Yugoslav Republics where thedata were collected from the Ministries of Health (MOH), the Statistical Offices and the National HealthInsurance Funds (HIF). Financial data were collected in nominal local currency units. Macroeconomicdata needed for tre-n analysis (e.g. GDP,- public expenditures) are those contained in World Bankeconomic reports. It should be emphasized that the macroeconomic data used in this study were thoseavailable at the time of analysis, and may be subject to change. Real trends in revenues and expenditures
'For information on, and access to, the WHO Health for All database for Europe, contact WHO Regional Office forEurope, Copenhagen, Denrark.
2World Health Organization, 1995. World Health Statistics Annual 1994. Geneva.
3World Health Organization, 1994. World Health Statistics Annual 1993. Geneva.
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were derived by deflating nominal time series data with GDP deflators. In addition to the health financedata obtained in the field, up-to-date information on privatization, private sector development, utilizationof health services and quality of care was only available -- if available at all -- through field work. Thevarious data sources by country are discussed below.
Albania: Government budgets provided information on health expenditures, by categories such aspersonnel expenditures and drugs. Administrative expenditures were included under the "other"expenditure category. However, the existing MIS does not provide data on expenditures regarding publichealth activities. Very little data on health status and health service indicators were available.
Bulgaria: The expenditures are classified into two categories: Municipal and Republican budgets. TheMunicipal budgets are responsible for personal health services in the various municipalities and the Sofiaregion. However, only the Republican budget, which is directly under the jurisdiction of the MOH,allocates resources for public health related activities. The data on personal health services weregenerated by subtracting the consolidated budget from the public health budget of the Republican budget.Limited information was available on medical education and research. The data on expenditures wereprovided by the MOF, while the data on salaries, number of employees and epidemiological indicatorswere provided by the MOH. Only the administrative budget for the MOH at the Republican level wasavailable. At the Municipal level, the administrative units cover a number of sectors ranging fromagriculture to health and education and were not disaggregated by sectors.
Croatia: Personal health services in Croatia are financed through the NHI and the private out-of-pocketexpenditures of individuals and corporations. Since 1993, the balance sheets of all public hospitals andhealth centers have been sent to the MOH where they are compiled and their total annual expenditurescalculated. Thus, for 1993 and 1994, detailed breakdowns of personal health services were madeavailable. Before 1993, the data were compiled and reported by the National Statistical Institute in itsannual Statistical Yearbooks. The MOH budget provides for public health services and administrativeexpenses, the latter included under the "other" expenditures category. Limited data on medical educationwere provided by the Ministry of Science and Technology. Data on salaries and medical personnel werecompiled from the Statistical Yearbooks, and the epidemiological data from the National Public HealthInstitute. Until 1991, the expenditures were expressed in thousands of Croatian denars and since 1992 inthousands of kunas. The currency units were not normalized, due to the magnitude of the change inunits. However, the various indicators were adjusted to account for this change.
Czech Republic: The MOF provided data on health expenditures by category until 1991. Since 1992,the data by categories have been obtained from the National Income Accounts (NIA), prepared by theCentral Statistical Office. The MOH expenditures cover only public health and administrative activities.Although information on total capital expenditures was provided by the MOF, the existing MIS cannotdisaggregate them by various categories such as vehicles and equipment. The data on NHI wereobtained from the MOF and the General Health Insurance Company (GHIC). The GHIC also providedinformation on its reimbursement to the private sector doctors, both at home and abroad. The Institute ofHealth Information and Statistics provided the epidemiological indicators and health services data to theWHO for its Health for All database. The data on average levels of salaries for doctors and nurses wereprovided by the Ministry of Labor (MOL). The financial data for 1993 and 1994 derived from the NIAare tentative, and subject to change.
FYR Macedonia: Personal health services in FYR Macedonia are financed mostly through the NHI andprivate out-of-pocket expenditures of individuals and corporations. Beginning in 1992, the balancesheets of all public hospitals and health centers have been sent to the Health Insurance Fund (HIF) wherethey are compiled and total annual expenditures are calculated. However, the current MIS only providesfor the breakdowns of certain categories of personal health services. These data were compiled and
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reported by the country's Statistical Office in its annual Statistical Yearbooks. The MOH budgetprovides for public health services and its administrative expenditures. Data on education and researchand development were not provided. Data on salaries and medical personnel were compiled from theStatistical Yearbooks, and the epidemiological data from the National Public Health Institute.
Hungarv: The data on expenditures and revenue were obtained from the MOH and the NHI. Theadministrative expenditures of the MOH are included under "other" expenditures. The MOH alsoprovided information on hospital and non-hospital expenditures and limited information on salaries. Thedata on the number of employees were obtained from the MOH, and epidemiological indicators from theInstitute for Public Health.
Lithuania: The MOF provided data on public expenditures. However, the accounting system and theMIS have changed twice during the transition. Under the old Soviet system, energy and utilities andmaintenance were classified under "other" expenditures. Soon after independence in 1991, the systemwas changed, and transportation and consumables/other materials were included under "other"expenditures. Since 1993, the categories were split further into energy/utilities, maintenance,transportation, consumables/supplies and "other" expenditures. For 1993 and 1994, "other" categoriesinclude only such items as stipends and MOH administrative expenditures. Currency changes have alsocomplicated matters. For 1987-1991, the expenditure data were expressed in rubles, and for 1992 intalonas. In 1993, litas became the unit of measure. Rubles and talonas were converted into litas usingthe appropriate conversion rate provided by the International Monetary Fund (IMF). Theepidemiological data were provided by the Statistical Institute, along with limited information on privateexpenditures.
Poland: At the time of the analysis, data were available only up to 1993. Furthermore, a detailedbreakdown was only available for the period 1991-1993. Moreover, for 1987 and 1988, only data onMOH expenditures were available. Direct charges were obtained from the Household Surveys and werecompiled by World Bank poverty specialists. Health expenditures, provided by the MOH, includeinformation on employees of the railways and health-related expenditures of other ministries for theperiod 1989-1993. The MIS at the MOH provided limited information on wages and salaries of medicalpersonnel. The Central Statistical Office compiled epidemiological data for Poland.
Romania: Information on health expenditures for all ministries and localities, by all categories with theexception of energy, was made available by the MOF for the period 1990-1994 and budgets wereprovided for 1995. However, the existing MIS and accounting systems do not account for expenditureson public health, medical education and research and development. "Other" expenditures includeadministrative expenditures of the MOH. For 1990-1995, the MIS also provided information by hospitaland non-hospital categories. The information on average wages and benefits, along with epidemiologicalinformation was provided by the MOH.
Slovakia: The MOF provided data on health expenditures by categories until 1991. Since 1992, the datawere obtained from the NHI Office. The epidemiological data were provided by the MOH. Slovakialacks disaggregated data, both on recurrent and capital expenditures. Although information on salarieswas available from the MOF, at the time of data collection the MIS aggregated all other categories intoconsumables/other supplies. This category includes a number of items ranging from heating andlighting, to drug supplies for personal health services. Information on capital expenditures, or on theadministrative expenditures of the MOH were not included. Finally, no data were available onreimbursement by public insurance schemes to doctors in the private sector, although the NHI providesreimbursements for a variety of services ranging from visits to private sector doctors, both at home andabroad.
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Slovenia: The MOF provided data on revenues and expenditures for 1993-95, while the MOH provideddata for the years prior to 1993. However, the administrative expenditures of the MOH were notincluded. The Institute of Macroeconomic Analysis and Development provided data on private insuranceand the MOL provided salary data. Until 1990, health revenues were contributions collected by specialfunds within the state budget. The distinction between the state budget and insurance was made onlyafter the implementation of the NHI. Epidemiological indicators were gathered from the Institute ofPublic Health of the MOH.
Turkkmenistan: Data on health revenues and expenditures were made available by the Ministry ofEconomy and Finance, while the data on epidemiological indicators and health services were availablefrom the MOH, for the period 1991-1994. The existing MIS did not account for expenditures before1991 or for any administrative expenditures. The situation was similar for health expenditures after1992.
Data Limitations
Several problems were encountered during data collection which were more severe in somecountries than others. These issues are discussed below by country.
Albania: The existing MIS does not provide data on allocations between hospitals and non-hospitals andsalaries of employees. Data on immunization and number of doctors were scant. However, a completeset of data on personal health services were made available, although these did not include anyinformation on public health expenditures. No data on wages and salaries of health personnel wereavailable.
Bulgaria: Detailed breakdowns by sub-categories of personal expenditures were available for 1989-1994. The existing MIS does not break down capital expenditures by various categories such asequipment and vehicles. Although a cost accounting system has been established, allocations betweenhospitals and non-hospitals were not provided. Data on average salaries were available for both doctorsand nurses only for the period, 1993-1995. There were significant gaps in the salary data prior to thisperiod. Furthermore, only the Republican part of the administrative expenditures was provided. Asseveral sectors are under the jurisdiction of the municipal level administration, the administrativeexpenditures at that level could not be included in the data. Another gap was the lack of data on medicaleducation and research and development. The epidemiological information in Bulgaria was strong,although information on 1994 was unavailable at the time of the study.
Croatia: Although financial and epidemiological data for Croatia were readily available, there werelimitations with the total expenditure information. The data included only the central governmentbudget, and not the extra-budgetary items, such as funds for pensions and health insurance. Thus, thefigure relating health expenditures to total expenditures is likely to be significantly over-estimated.Furthernore, a detailed breakdown of personal health services was not compiled prior to 1993.
Czech Republic Lack of disaggregated data on capital expenditures was the major gap in the Czech dataset. The disaggregated recurrent expenditure data for 1993 and 1994 are preliminary. While financialdata for 1994 were available, epidemiological indicators and health services data were unavailable.
ES Macedonia: At the time of writing, both financial and epidemiological data for 1994 were scant.Furthermore, no information on medical education and research and development expenditures wereavailable. Capital expenditure data were available only after 1991. Data on expenditure allocations byhospitals and non-hospitals were limited. Moreover, the Statistical Office only calculated the salarylevels for the sector as a whole, and for individual categories such as hospitals and health centers. Asignificant amount of epidemiological data was made available by the Statistical Office.
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Hungary: A large amount of information on recurrent health expenditures and health revenues wereavailable, including information on research and development and medical education for 1991-1994.However, the existing MIS was unable to provide a detailed breakdown of capital expenditures. Data onsalaries of medical personnel were limited. Furthermore, there were significant gaps in theepidemiological and health services data, especially afterT992.
Lithuania: Frequent changes in budget methodology make comparisons across years and with othercountries difficult. Expenditures could not be categorized as hospital or non-hospital expenditures.Private expenditures were unreliable due to sampling bias. Only 450 households were surveyed andrural areas of the country were not adequately covered in the sample. No information on wages andsalaries of health professionals were available.
Poland: Data for 1994 were not available at the time of analysis. Detailed breakdowns of capitalexpenditures, and salaries and expenditure allocations by hospitals were unavailable. The situation wassimilar for epidemiological and health personnel data.
Romania: Data on research, public health and medical education expenditures were not provided. Nodisaggregated capital expenditures were available. I
Sloyakia: The existing MIS provides very little data on disaggregated recurrent expenditures andreimbursement by the public sector to private doctors. Little or no information on capital expenditures orthe administrative expenditures of the MOH was available. Epidemiological data and information onhealth services were available for the period 1987-1992. However, there were significant gaps for both1993 and 1994. Furthermore, expenditures could not be allocated by hospital and non-hospitalcategories, and no information on wages and salaries of health professionals was accessible.
Slovenia: Detailed breakdowns of personal health services were available, although no information wasprovided for medical training, public health services and research and development, or administrativeexpenditures of the MOH or the Health Insurance Fund. Capital expenditures were mostly concentratedon equipment. Expenditure allocations by hospitals and non-hospitals were provided for the period1987-1993 and information on salaries were also provided for the same period. Epidemiological dataand information on the number of medical personnel were available for most categories for the period1987-1993, but corresponding data for 1994 were not available.
Turkmenistan: The MIS did not provide health financing data before 1991, or epidemiological andhealth services data since 1992. Little, or no, disaggregated data regarding capital expenditures wereavailable. Furthermore, no data on the administrative expenditures of the MOH were available.Expenditures could not be allocated by hospital and non-hospital categories, and no information onwages and salaries of health professionals was available.
For all of the countries, information on the emerging private sector was rare or non-existent.Although for some countries, such as Bulgaria, data were available regarding the number of privatedoctors and nurses. Information on revenues earned by the private sector was not available for anycountry.
Finally, it should be emphasized that it was difficult to obtain a comprehensive overview offoreign assistance. Technical assistance and loans have become an important category in recent years,especially since the onset of major reforms. In most developing countries, particularly Africa and SouthAsia, the United Nations Development Program (UJNDP) keeps track of this information, both accordingto the project and year, in the publication "Development Cooperation." This document greatly assists indonor coordination, and helps in avoiding overlap and duplication of project-related activities. However,accurate total estimates of donor grants and loans are not available.
I
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CHAPTER II: STATISTICAL TEMPLATES
Table of Contents
Section I: General Indicators ........................................................................ 8
Table 1. General Indicators: Albania, Bulgaria, Croatia, Czech, Hungary, Lithuania, FYRMacedonia, Poland, Romania, Slovakia, Slovenia, Turkmenistan.
Section II: Sources of Health Financing and Expenditures .................................................................. 13
Sources of Financing and Expenditure: A. Health Financing; B. Health Financing (DeflatedExpenditures, 1990=100); C. Health Financing (% GDP); D. Health Financing (% Total Expenditures)
Table 2. Albania
Table 3. Bulgaria
Table 4. Croatia
Table 5. Czech Republic
Table 6. FYR Macedonia
Table 7. Hungary
Table 8. Lithuania
Table 9. Poland
Table 10. Romania
Table 11. Slovakia
Table 12. Slovenia
Table 13. Turkmenistan
Section III: Health Status and Services ....................................................................... 63
Health Status and Services: A. Lifestyles and Healthy Environment; B. Appropriate Care; C. HealthStatus.
Table 14. Albania
Table 15. Bulgaria
Table 16. Croatia
Table 17. Czech Republic
Table 18. FYR Macedonia
Table 19. Hungary
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Table 20. Lithuania
Table 21. Poland
Table 22. Romania
Table 23. Slovakia
Table 24. Slovenia
Table 25. Turkmenistan
This chapter discusses the data which were analyzed in the main report. The first sectiondiscusses the macroeconomic indicators used in the analysis, and the second provides generalinformation on the financial data and indicators. The third section contains general information onepidemiological and demographic indicators, and delivery of health services. Further definitions areavailable in the Glossary (Chapter IV). The discussions in each section are accompanied by acorresponding data set.
Section I: General Indicators
Indicators for this study were derived using selected macroeconomic variables including theGross Domestic Product (GDP), total expenditures and the GDP deflators (1990=100). The GDP(nominal) was used to calculate health expenditures as a proportion of GDP. Total expenditures(nominal) are the sum of total government expenditures at the central, state and local levels. Theseexpenditures were also used to calculate health expenditures as a proportion of total governmentexpenditures. The population is the total estimated mid-year population for each individual country. Allexpenditure and GDP data are expressed in local currency.
The GDP index for each country was calculated based on the GDP deflator, with 1990 as thebase year for all countries except Turkmenistan, where 1991 was used as the base year. For example, theGDP index for 1994 is the deflated GDP for 1994 divided by the deflated GDP for 1990, multiplied by100.
The macroeconomic variables used in these calculations were current at the time of analysis, andmay differ from more recent World Bank figures.
TABLE 1. CEE COUNTRIES: GENERAL INDICATORS
Indicators, l _l 1987 1988 1989 1990 1991 1992 1993 1994 1995AlbaniaGDP Million Leks 17,253 17,008 18,681 16,813 16,474 48,477 113,041 166,297 204,500Total Expenditures Million Leks 10,449 10,202 22,910 45,515 57,332 58,962Population Millions 3.08 3.14 3.20 3.26 3.32 3.38 3.43 3.48 3.26GDP Deflator 1990=100 1.00 1.00 1.00 1.00 1.36 3.67 15.23 19.92 14.00Deflated GDP Index 17,253 17,008 18,681 16,813 12,158 13,227 7,425 8,350 14,607GDP Index Index 102.62 101.16 111.11 100.00 72.31 78.67 44.16 49.67 86.88Total Exp. Deflated Million Leks 10,449 7,529 6,251 2,989 2,879 4,212
BulgariaGDP Million Levas 36,531 38,345 39,579 45,391 131,058 202,956 286,134 543,474 831,515Total Expenditures Million Levas 22,000 22,400 23,200 26,200 60,947 92,404 150,233 239,844 375,133Population Millions 8.72 8.69 8.64 8.61 8.57 8.52 8.47 8.43GDP Deflator 1990=100 0.79 1.00 3.25 5.54 9.14 12.07 14.66Deflated GDP Index 50,266 45,391 40,301 36,613 31,300 45,024 56,720GDP Index Index 110.74 100.00 88.79 80.66 68.96 99.19 124.96Total Exp. Deflated Million Levas 29,464 26,200 18,741 16,669 16,434 19,870 25,589
CroatiaGDP 000 HRD/Kuna 1,221,800 3,663,800 47,253,900 276,158,400 451,436,100 3,366,729 52,436,541 82,600,000 94,560,000Total Expenditures 000 HRDlKuna 173,720,000 1,406,800 15,263,630 38,032,590 46,255,000Population 000 4,674 4,681 4,685 4,770 4,789 4,782 4,779 4,775 4,778GDP Deflator 1990=100 1.00 2.04 15.81 252.91 490.31 584.30GDP Deflated Index 276,158 221,292 212,949 207,333 168,465 180,365GDP Index Index 100.00 80.13 77.11 75.08 1 61.00 65.31Total Exp. Deflated 000 HRDlKuna 85,156,863 88,982 60,352 77,568 88,2Z2
Czech Republic /GDP Million Kc 495,100 513,400 524,600 567,300 716,600 791,000 910,600 1,037,500 1,260,070Total Expenditures Million Kc 385,100 447,300 511,800 590,300Population Millions 10.28 10.29 10.30 10.31 10.31 10.33 10.34 10.36 10.37GDP Deflator 1990=100 1.00 1.47 1.73 2.01 2.23 2.50GDP Deflated Index 567,300 487,483 457,225 453,035 465,247 504,028GDP index Index 100.00 85.93 80.60 79.86 82.01 88.85Total Exp. Deflated Million Kc 222,601 222,537 229,507 236,120
TABLE 1. CEE COUNTRIES: GENERAL INDICATORS
Indicators 1987 1988 1989 1990 1991 1992 1993 1994 1995FYR MacedoniaGDP 000 Denars 585,000 904,000 11,685,000 60,256,000 128,517,000 136,455,000Total Expenditures 000 Denars 459,000 5,792,000 31,690,000 67,348,000 67,890,000Population Thousands 1,995 2,007 2,018 2,028 2,039 2,056 2,073 2,215 2,119GDP Deflator 1990=100 1.00 1.71 25.24 148.71 334.68 371.90Deflated GDP Index 585,000 528,655 462,956 405,191 384,000 366,913GDP Index Index 100.00 90.37 79.14 69.26 65.64 62.72Total Exp. Deflated 000 Denars 268,421 229,477 213,099 201,231 182,549
HungaryGDP Million HUF 1,226,400 1,440,400 1,722,800 2,089,300 2,347,600 2,885,600 3,502,600 4,314,100 5,617,300Total Expenditures Million HUF 738,700 892,300 1,041,500 1,194,500 1,345,600 1,778,100 2,004,900 3,103,700Population Millions 10.62 10.60 10.58 10.55 10.48 10.41 10.34 10.23 10.23GDP Deflator 1990=100 0.61 0.73 0.80 1.00 1.35 1.64 2.04 2.44GDP Deflated Index 2,010,492 1,973,151 2,153,500 2,089,300 1,738,963 1,759,512 1,716,961 1,768,074GDP Index Index 96.23 94.44 103.07 100.00 83.23 84.22 82.18 84.63Total Exp. Deflated Million HUF 1,210,984 1,222,329 1,301,875 1,194,500 996,741 1,084,207 982,794
LithuaniaGDP Million Litas 110.00 118.00 127.00 133.00 382.00 3386.70 11107.90 16980.70 24000.00Total Expenditures Million Litas 41.00 45.00 48.00 47.00 149.00 1070.00 3910.00 6950.00 10000.00Population Millions 3.64 3.67 3.70 3.72 3.74 3.74 3.73 3.72 3.71GDP Deflator 1990=100 0.85 0.84 0.89 1.00 4.31 53.35 249.89 377.33 490.50Deflated GDP Index 129.56 140.81 142.86 133.00 88.63 63.48 44.45 45.00 48.93GDP Index Index 97.42 105.87 107.41 100.00 66.64 47.73 33.42 33.84 36.79Total Exp. Deflated Million Litas 48.29 53.70 53.99 47.00 34.57 20.06 15.65 18.42 20.39
PolandGDP Billion Zlotys 16,940 29,629 118,319 560,271 808,829 1,149,442 1,557,800 2,077,000 2,900,000Total Expenditures Billion Zlotys 6,389 10,610 47,157 244,243 395,832 595,105 777,999 1,044,136 1,473,473Population Billions 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04 0.04GDP Deflator 1990=100 0.03 0.04 0.19 1.00 1.55 2.15 2.81 3.61 4.58GDP Deflated Index 564,663 740,718 622,730 560,271 521,825 534,624 554,377 575,346 633,188GDP Index Index 100.78 132.21 111.15 100.00 93.14 95.42 98.95 110.26 118.44Total Exp. Deflated Billion Zlotys 212,967 265,250 248,195 244,243 255,375 276,793 276,868 289,234 321,719
TABLE 1. CEE COUNTRIES: GENERAL INDICATORS
Indicators 11987 1988 11989 1990 1991 1992 1993 1994 1995RomaniaGDP Million Lei 845,200 857,000 800,000 857,900 2,203,900 6,083,500 19,737,500 46,607,500 64,861,000Total expenditures Million Lei 281,426 286,686 288,426 310,863 537,874 1,626,908 6,798,200 16,952,000 24,912,000Population Millions 22.94 23.05 23.15 23.21 23.19 22.79 22.76 22.73 22.70GDP Deflator (1990= 1990=100 0.87 0.87 0.87 1.00 2.95 9.29 28.95 67.37 88.25Deflated GDP Index 971,494 985,057 919,540 857,900 747,085 654,844 681,779 691,814 734,969GDP Index Index 113.24 114.82 107.19 100.00 87.08 76.33 79.47 80.64 85.67Total Exp. Deflated Million Lei 323,478 329,524 331,524 310,863 182,330 175,125 234,826 251,625 282,289
SlovakiaGDP Million Sk 216,900 237,500 237,500 257,100 295,700 301,800 340,800 396,600 458,200Total Expenditures Million Sk 192,600 189,500 208,800 237,767Population Millions 5.23 5.26 5.28 5.30 5.33 5.35 5.37 5.39 5.40GDP Deflator 1990=100 0.93 1.00 1.34 1.49 1.72 1.92 2.14GDP Deflated Index 255,376 257,100 220,672 202,550 198,140 206,563 214,112GDP Index Index 99.33 100.00 85.83 78.78 77.07 80.34 83.28Total Exp. Deflated Milion Sk 129,262 110,174 108,750 111,106
SloveniaGDP Million Tolars 248,221 349,558 1,005,261 1,434,974 1,808,100 2,162,500Total Expenditures Million Tolars 93,486 143,553 464,159 671,110 855,273 1,002,422Population Millions 2.00 2.00 2.01 2.01 2.01 2.01GDP Deflator 1990=100 0.76 1.00 1.97 5.99 8.01 10.17 12.33Deflated GDP Index 248,221 177,441 167,823 179,148 177,788 175,385GDP Index Index 100.00 71.48 67.61 72.17 71.62 70.66Total Exp. Deflated Million Tolars 93,486 72,870 77,489 83,784 84,098 81,299
TurkmenistanGDP 000 Manats 34,000 653,000 11,051,000 205,312,000 674,852,000Total Expenditures 000 Manats 20,000 378,000 2,172,000 15,287,000 128,200,000Population 000 3,800 3,950 4,200 4,406 4,650GDP Deflator Index 1.00 20.22 360.14 7434.80 30550.11Deflated GDP 000 Manats 34,000 32,300 30,685 27,615 22,090GDP Index Index 100.00 95.00 90.25 81.22 64.97Total Exp. Deflated 000 Manats 20,000 18,697 6,031 2,056 4,196
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Section II: Sources of Health Financing and Expenditures
This section discusses the indicators associated with health care financing. Health financing datawere divided into health revenues and health expenditures for both private and public categories.Similarly, government health expenditures (public) are categorized into recurrent and capitalexpenditures. The following briefly discusses these indicators:
(i) Health revenues in the public sector. In the public sector, health revenues include the state budget,which is a sum of all expenditures by the central, provincial and local budgets. The data do not includebudgets (or actual expenditures incurred) of the NHI in countries such as Slovenia. The NHI isessentially the budget for the state-run insurance organizations for the given year. In most cases, directcharges are the revenues from user fees in public hospitals. Borrowing by public sector organizationsincluding the MOH is included under this category.
(ii! Health revenues in the private sector. Private sector revenues include the revenues or budgets ofprivate sector health insurance organizations -- which are still in their infancy in most CEE countries --as well as direct charges levied by private hospitals, doctors and health centers.
(iii) Recurrent Expenditures. This category is comprised of personal health services, public healthactivities, medical education and research and development. Personal health services include anyservices dealing directly with a patient. In most countries, activities such as immunization, and othersrelated to primary and ambulatory health care, are provided by hospitals. Hence, it was difficult toseparate primary, secondary and tertiary health care activities. The personal health care activities areclassified into personnel (wages and social security), drugs, other consumable/supplies, energy/utilities,maintenance, transportation and "other" categories. Public health activities have a significant butindirect impact on the health status of the population. Medical education includes all education related tohealth professional training, including training of auxiliaries and midwives. Research and developmentactivities include those that are directly connected to improving the health of the population.
(iv) Capital expenditures. These include construction of new health facilities and renovation of olderones, as well as equipment and vehicles purchased.
(v) Public reimbursements to private sector. This category is the payments made by the public insuranceagencies to private facilities including individual private physicians. It captures the amount publiclyfinanced by the government through health insurance schemes and provided by private facilities. Such acategory illustrates the main reasons for escalating costs in countries with NHI.
(vi) Private sector expenditures. These include reimbursements by private insurance organizations forservices provided and direct private out-of-pocket expenditures.
(vii) Hospital and non-hospital expenditures. Attempts were also made to allocate expendituresaccording to hospitals and non-hospitals, separating curative from non-curative activities. Hospitalexpenditures were further classified into expenditures on in-patients and out-patients.
(viii) Average salaries (wages and benefits). This category includes the average salary for the sector,specifically for doctors and nurses.
TABLE 2A. ALBANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 11987 1988 1989 1990 1991 1992 1993 1994 1995Heaflth Revenues Million Leks 509.70 528.30 544.50 558.90 793.80 1,630.00 3,412.00 4,720.00 5,300.00Public 509.70 528.30 544.50 558.90 793.80 1,630.00 3,412.00 4,720.00 5,300.00
State Budget 509.70 528.30 544.50 558.90 793.80 1,630.00 3,412.00 4,720.00 5,300.00National Health Insurance _ _ _ _ _ _ _ _Direct Charges (Public) _Borrowing - _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - - -
Private - - - - - - - - -Private Insurance - - - - - - - - -Direct Charges (Private) - - - - - - - - -
Health Expenditure Million Leks 508.70 527.30 543.50 562.90 722.80 1,619.10 3,397.00 4,700.00 5,550.00Public 508.70 527.30 543.50 562.90 722.80 1,619.10 3,397.00 4,700.00 5,550.00Recurrent Expenditure 469.50 486.80 503.50 527.20 680.00 1543.60 3,112.00 4,377.00 5,170.00
Personal Health Services 465.30 481.80 498.50 522.20 670.00 1,528.60 3,092.00 4,354.00 5,140.00Personnel (Wage/Benetits) 222.50 230.40 240.00 251.00 330.00 571.00 960.00 2,233.00 2,650.00Drugs 50.00 54.60 61.30 60.00 80.00 240.00 567.00 724.00 1,000.00Other Consumables/Supplies 59.00 62.80 80.50 81.00 70.00 250.00 450.00 520.00 700.00Energy/Utilities 3.00 3.00 3.50 3.50 5.00 10.00 15.00 20.00 30.00Maintenance 58.00 60.70 64.00 67.00 95.00 302.00 530.00 560.00 650.00Transportation 20.00 21.00 22.00 22.00 40.00 40.00 60.00 87.00 110.00Other 52.80 49.30 27.20 37.70 50.00 115.60 510.00 210.00 -
Public Health Activities - - - - - - - - -Medical Education 1.00 1.00 1.00 1.00 2.00 5.00 5.00 5.00 5.00Research And Development 3.20 4.00 4.00 4.00 8.00 10.00 15.00 18.00 25.00
Capital Expenditures 39.20 40.50 40.00 35.70 42.80 75.50 285.00 323.00 380.00Constructon 3.20 3.20 2.50 3.00 4.00 10.50 20.00 25.00 90.00
New 23.00 24.00 25.60 22.70 28.80 30.00 95.00 88.00 100.00Rehabiltation 4.00 4.30 4.90 5.00 5.00 25.00 70.00 90.00 90.00
Equipment 9.00 9.00 7.00 5.00 5.00 10.00 100.00 120.00 100.00Vehicles 1.00 1.00 1.00 1.00 1.00 10.00 15.00 20.00 20.00
Public Reimbursements to Private Sector Million Lek - - - - - - - - -Private Sector _ _ - _ l - _ _
Private Insurance Reimbursemnent _ _ - _ l - _ _Private Expenditures _ _ _ _ _ - _ _
Expenditure Allocation Milion Laeks e _ | _ l | _ _
In-patient _ _ - _ _ I _ _Out-patent _ __ __
Non-Hospitals
Average salary (Wages + Benefts) LekslMonth _ | _ _ _ Average For Sector _ _ _ _ _ l _ _ lDoctors l _ l _ _ l _ _Nurses -- -----
TABLE 2B. ALBANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995
(Deflated Expenditures, 1990=100)Health Revenues Million Leks 509.70 528.30 544.50 558.90 585.83 444.75 224.11 237.01Public 509.70 528.30 544.50 558.90 585.83 444.75 224.11 237.01
State Budget 509.70 528.30 544.50 558.90 585.83 444.75 224.11 237.01National Health Insurance -- - - -- - -- - --
Direct Charges (Public) _ _ _
Borrowing _ _ _ _
Foreign Assistance (Loans/Grants) _ _ _ _
Private _ _ _
Private Insurance -- - -- - -- --
Direct Charges (Private)
Health Expenditure Million Leks 508.70 527.30 543.50 562.90 533.43 441.77 223.12 236.00Public 508.70 527.30 543.50 562.90 533.43 441.77 223.12 236.00Recurrent Expenditure 469.50 486.80 503.50 527.20 501.85 421.17 204.40 219.78
Personal Health Services 465.30 481.80 498.50 522.20 494.46 417.08 203.09 218.63Personnel (Wage/Benefits) 222.50 230.40 240.00 251.00 243.54 155.80 63.05 112.13Drugs 50.00 54.60 61.30 60.00 59.04 65.48 37.24 36.35Other Consumables/Supplies 59.00 62.80 80.50 81.00 51.66 68.21 29.56 26.11Energy/Utilities 3.00 3.00 3.50 3.50 3.69 2.73 0.99 1.00Maintenance 58.00 60.70 64.00 67.00 70.11 82.40 34.81 28.12Transportation 20.00 21.00 22.00 22.00 29.52 10.91 3.94 4.37Other 52.80 49.30 27.20 37.70 36.90 31.54 33.50 10.54
Public Health Activities -- -- -- -- -- - - -
Medical Education 1.00 1.00 1.00 1.00 1.48 1.36 0.33 0.25Research And Development 3.20 4.00 4.00 4.00 5.90 2.73 0.99 0.90
Capital Expenditures 39.20 40.50 40.00 35.70 31.59 20.60 18.72 16.22Construction 3.20 3.20 2.50 3.00 2.95 2.86 1.31 1.26
New 23.00 24.00 25.60 22.70 21.25 8.19 6.24 4.42Rehabilitation 4.00 4.30 4.90 5.00 3.69 6.82 4.60 4.52
Equipment 9.00 9.00 7.00 5.00 3.69 2.73 6.57 6.03Vehicles 1.00 1.00 1.00 1.00 0.74 2.73 0.99 1.00
Public Reimbursements to Private Sector - -- -- -- -- -- -- -
Private SectorPrivate Insurance Reimbursement _ -
Private Expenditures
Expenditure Allocation Million Leks -
HospitalsIn-patientOut-patient
Non-HospitalsAverage salary (Wages + Benefits) LekslMonth _Average For SectorDoctorsNursesII I -- I
TABLE 2C. ALBANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 19951% GDP)Health Revenues % 2.95% 3.11% 2.91% 3.32% 4.82% 3.36% 3.02%h 2.84h -Public 2.95% 3.11% 2.91% 3.32% 4.82% 3.36% 3.02% 2.84%A
State Budget 2.95% e 3.11% 2.91% 3.32% 4.82% 3.36% 3.02% 2.84%National Health Insurance - - - - - - - -Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) _ _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ _
Health Expenditure % 2.95% 3.10% 2.91% 3.35% 4.39% 3.34% 3.01% 2.83% -Public 2.95% 3.10% 2.91% 3.35% 4.39% 3.34% 3.01% 2.83% -
Recurrent Expenditure 2.72% 2.86% 2.70% 3.14% 4.13% 3.18% 2.75% 2.63% -Personal Health Services 2.70% 2.83% 2.67% 3.11% 4.07% 3.15% 2.74% 2.62% -
Personnel (Wage/Benefits) 1.29% 1.35% 1.28% 1.49% 2.00% 1.18% 0.85% 1.34% -Drugs . 0.290% 0.32% 0.33% 0.36% 0.49% 0.50% 0.50% 0.44% -Other Consumables/Supplies 0.34% 0.37% 0.43% 0.48% 0.42% 0.52% 0.40% 0.31% -EnergyAt.ilities 0.02% 0.02°6 0.02%o 0.02% 0.03% 0.02°h 0.01% 0.01% -Maintenance 0.34% 0.36% 0.34% 0.40% 0.58% 0.62% 0.47% 0.34% -Transportation 0.12% 0.12% 0.12% 0.13% 0.24% 0.08% 0.05% 0.05% -Other 0.31% 0.29% 0.15% 0.22% 0.30% 0.24% 0.45% 0.13% -
Public Health Activides _ _ _ _ _ _ _ _Medical Education 0.01% 0.01% 0.01% 0.01% 0.01% 0.01% 0.00% 0.00% -
Research And Development 0.02% 0.02% 0.02% 0.02% 0.05% 0.02% 0.01% 0.01% -
Capital Expenditures 0.23% 0.24% 0.21% 0.21% 0.26% 0.16% 0.25% 0.19% -
Construction 0.02% 0.02% 0.01% 0.02% 0.02% 0.02% 0.02% 0.02% -New 0.13% 0.14% 0.14% 0.14% 0.17% 0.06% 0.08% 0.05% -
Rehabilitation 0.02°h 0.03% 0.03% 0.03% 0.03% 0.05% 0.06% 0.05% -Equipment 0.05% 0.05% 0.04% 0.03% 0.03% 0.02% 0.09% 0.07%Vehicles 0.01% 0.01% 0.01% 0.01% 0.01% 0.02% 0.01% 0.01% -
Public Reimbursements to Private Sector - - - - - - - - -PrWvate Sector
Private Insurance Reimbursement _ _ _ _ _ _ _ _Private Expenditures _ _ _ _ . _ _
TABLE 2D. ALBANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995
(% Total Expenditures)Health Revenues % -- -- - 5.35% 7.78% 7.11% 7.50% 8.23%Public _ - 5.35% 7.78% 7.1111% 7.50% 8.23%
State Budget _ - 5.35% 7.78% 7.11% 7.50% 8.23%National Health Insurance _ _ _ _ _Direct Charges (Public)BorrowingForeign Assistance (LoanslGrants) _ _ _ _ _ _ ,
PrivatePrivate InsuranceDirect Charges (Private)
Health Expenditure % _ _ 5.39% 7.08% 7.07% 7.46% 8.20%Public _ 5.39% 7.08% 7.07% 7.46% 8.20%Recurrent Expenditure _ _ 5.05% 6.67% 6.74% 6.84% 7.63%
Personal Health Services _ 5.00% 6.57% 6.67% 6.79% 7.59%Personnel (Wage/Benefits) _ _ 2.40% 3.23% 2.49% 2.11% 3.89%Drugs _ 0.57% 0.78% 1.05% 1.25% 1.26%
Other ConsumablestSupplies 0.78% 0.69% 1.09% 0.99% 0.91%Energy/Utilities _ 0.03% 0.05% 0.04% 0.03% 0.03%Maintenance _ 0.64% 0.93% 1.32% 1.16% 0.98%Transportation _ 0.21% 0.39% 0.17% 0.13% 0.15%Other 0.36% 0.49% 0.50% 1.12% 0.37%
Public Health Activities _ _ _Medical Education _ _ 0.01% 0.02% 0.02% 0.01% 0.01%
Research And Development 0.04% 0.08% 0.04% 0.03% 0.03%
Capital Expenditures _ 0.34% 0.42% 0.33% 0.63% 0.56%Construction _ 0.03% 0.04% 0.05% 004% 0.04%
New 0.22% 0.28% 0.13% 0.21% 0.15%
Rehabilitation _ 0.05% 0.05% 0.11% 0,15% 0.16%Equipment _ _ 0.05% 0.05% 0.04% 0.22% 0.21%
Vehicles _ _ | 0.01% 0.01% 0.04% 0.03% 0.03%Public Reimbursements to Private Sector -- - -- -- -
Private SectorPrivate Insurance Reimbursement l - _Private Expenditures _ _ _ .____.
TABLE 3A. BULGARIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million Levas - 1,620.26 1,780.01 2,356.62 7,124.40 13,815.13 14,723.40 21,943.10 33,214.50Public - 1,620.26 1,780.01 2,356.62 7,124.40 13,815.13 14,723.40 21,943.10 33,214.50
State Budget - 1,245.30 1,354.20 1,855.50 5,919.00 10,995.60 14,723.40 21,943.10 33,214.50National Health Insurance 5012 1 2,19 -_Direct Charges (Public) - 374.96 425.81 501.12 1,205.40 2,819.53Borrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) _ - _- - - - -
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) _ - _ _ _ _ _
Health Expenditure Million Levas - 1,195.30 1,276.20 1,778.00 5,627.90 10,514.40 14,180.40 21,183.70 31,851.50Public - 1,195.30 1,276.20 1,778.00 5,627.90 10,514.40 14,180.40 21,183.70 31,851.50Recurrent Expenditure - 1,166.30 1,247.20 1,749.00 5,598.90 10,485.40 14,151.40 21,154.70 31,822.50
Personal Health Services - - 1,230.50 1,730.40 5,413.60 10,179.80 13,071.90 19,582.30 29,798.70Personnel (Wage/Benefits) - - 606.70 984.10 2,662.50 4,783.30 6,969.20 10,387.70 16,267.40Drugs - - 196.30 212.20 837.60 2,089.60 2,197.70 3,629.90 5,151.00Other Consumables/Supplies - - 311.90 350.60 1,479.60 2,305.60 2,642.50 3,964.50 6,020.30Energy/Utilities _ _ _ _ _ _ _ _Maintenance - - 115.30 182.60 432.00 999.50 1,243.20 1,541.30 2,256.50Transportation - - - - - - 16.90 17.80 32.90Other - - 0.30 0.90 1.90 1.80 2.40 41.10 70.60
Public Health Activities - - - - - - 764.60 1,158.40 1,505.10Medical Education - - - - 136.50 229.10 234.70 299.60 350.50Research And Development - 15.30 16.70 18.60 48.80 76.50 80.20 114.40 168.20
Capital Expenditures - 79.00 107.00 106.50 320.10 510.20 572.00 788.40 1,392.00Construction _ _ _ _ _ _ _ _
New _ l _ _ l l _ lRehabilitation _ - _ _ _ - _ _
Equipment - - - - - - - - -Vehicles _ _ _ _ _ _ _ l
Public Reimbursements to Private Sector - - - - - - - - -Private Sector _ l _ _ l _ _ l l
Private Insurance Reimbursement - - - - - - - - -Private Expenditures _ _ _ - _ _ _ _
Expenditure Allocation Million Levas - - - - - - - - -Hospitals _ _ _ - _ _ _ _
In-patient _ l l l f _ _ _Out-patient _ - _ - _ _ _ _
Non-Hospitals _ _ _ _ _Average salary (Wages " Benefits) Levas/Month - - - - - - - - _Average For Sector - - - 432.00 1,207.00 2,257.00 3,805.00 7,419.00Doctors - - - 531.00 - - 6,692.00 10,140.00 12,123.00Nurses _ _ - 312.00 - _ 2,934.00 6,487.00 10,945.00
TABLE 3B. BULGARIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues Million Levas - - 2,260.61 2,356.62 2,190.0 2,492.22 1,610.57 1,817.86 2,26565Public - - 2,260.61 2,356.62 2,19i.80 2,492.22 1,610.57 1,817.86 2,265.65
State Budget - - 1,719.83 1,855.50 1,820.13 1,983.58 1,610.57 1,817.86 2,265.65National Health Insurance _ _ _ _ _ _ _Direct Charges (Public) - - 540.78 501.12 370.67 508.64 _ _Borrowing _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - _ _ _
Private _ _ _ _ _Private Insurance _ _ _ _ _Direct Charges (Private) _ _ _ _ _
Health Expenditure Million Levas _ - 1,719.83 1,858.50 1,820.13 1,983.58 1,610.57 1,817.86 2,265.65Public _ - 1,719.83 1,855.50 1,820.13 1,983.58 1,610.57 1,817.86 2,265.65Recurrent Expenditure _ - 1,583.94 1,749.00 1,721.70 1,891.54 1,548.00 1,752.54 2,170.70
Personal Health Services - - 1,562.74 1,730.40 1,664.71 1,836.41 1,429.91 1,622.28 2,032.65Personnel (Wage/Benefits) - - 770.51 984.10 818.73 862.90 762.35 860.56 1,109.65Drugs - - 249.30 212.20 257.57 376.96 240.40 300.72 351.36Other Consumables/Supplies - - 396.11 350.60 454.99 415.93 289.06 328.44 410.66Energy/Utilities _ _ _ _ _ _ - _Maintenance - - 146.43 182.60 132.84 180.31 135.99 127.69 153.92Transportation - - - - - - 1.85 1.47 2.24Other - - 0.38 0.90 0.58 0.32 0.26 3.40 4.82
Public Healeh Activiiies- - - - - - 83.64 95.97 102.67Medical Education - - - - 41.97 41.33 25.67 24.82 23.91Research And Development - - 21.21 18.60 15.01 13.80 8.77 9.48 11.47
Capital Expenditures . - 135.89 106.50 98.43 92.04 62.57 65.31 94.95Construction
New _ _ _ l _ _ _Rehabilitation _ _ l _ _ _
Equipmnent _ _ _ l _ _ _ _Vehicles _ _ l _ _ _
Public Reimbursements to Private Sector - - - - - - - - -
Private Sector _ _ _ - _ _ _ _ _Private Insurance Reimbursement - - - - - - - -Private Expenditures _ _ l _ _ _
Expenditure Allocation Million Levas - - - - - - -Hospitals _
In-patientOut-patient _
Non-Hospitals _Average salary (Wages + Benefits) Levas/Month - . -_ l _ _ - _Average For Sector - _ - 432.00 371.16 407.16 416.22 614.621 -
Doctors - _ _ 531.00 - - 732.03 840.04 826.94Nurses _ _ _ 312.00 - - 320.95 537.41 746.59
TABLE 3C. BULGARIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues %-- 4.23% 4.50% 5.19% 5.44% 6.81% 5.15% 4.04% 3.99%Public - 4.23% 4.50% 5.19% 5.44% 6.81% 5.15% 4.04% 3.99%
State Budget - 3.25% 3.42% 4.09% 4.52% 5.42% 5.15% 4.04% 3.99%National Health Insurance _ _ _ _ _ _ _ _Direct Charges (Public) - 0.98% 1.08% 1.10% 0.92% 1.39% _ _ _Borrowing _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - _ _ _ _ _ _
Private _Private Insurance _Direct Charges (Private) _
Health Expenditure % - 3.25% 3.42% 4.09% 4.52% 5.42% 5.15% 4.04% 3.99%Public - 3.25% 3.42% 4.09% 4.52% 5.42% 5.15% - 4.04% 3.99%Recurrent Expenditure - 3.04% 3.15% 3.85% 4.27% 5.17% 4.95% 3.89% 3.83%
Personal Health Services - - 3.11% 3.81% 4.13% 5.02% 4.57% 3.60% 3.58%Personnel (Wage/Benefits) - - 1.53% 2.17% 2.03% 2.36% 2.44% 1.91% 1.96%Dnrgs - - 0.50% 0.47% 0.64% 1.03% 0.77% 0.67% 0.62%Other ConsumableslSupplies - - 0.79% 0.77% 1.13% 1.14% 0.92% 0.73% 0.72%Energy/Utilities _ _ _ _ _ _ _Maintenance - - 0.29% 0.40% 0.33% 0.49% O.43% 0.28% 0.27%Transportation _ _ _ _ _Other _- - - 0.01% 0.01%
Public Health Activities - -- 0.27% 0.21% 0.18%Medical Education - - - _ 0.10% 0.11% 0.08% 0.06% 0.04%Research And Development - 0.04% 0.04% 0.04% 0.04% 0.04% 0.03% 0.02% 0.02%
Capital Expenditures - 0.21% 0.27% 0.23% 0.24% 0.25% 0.20% 0.15% 0.17%Construction
New _ _ _ _ _ _ _ _Rehabilitation _ _ _ -_ _ _ _ _
Equipment _ _ _ - _ - _ _Vehicdes
Public Reimbursements to Private Sector _ _ _Private Sector _ - _
Private Insurance Reimbursement - - - _ _ . _ _ _Private Expenditures - - . . _ __ _ __. _-__ _
TABLE 3D. BULGARIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues % -- 7.23% 7.67% 8.99% 11.69% 14.95% 9.80% 9.15% 8.85%Public - 7.23% 7.67% 8.99%b 11.69% 14.95% 9.80% 9.15% 8.85%
State Budget - 5.56% 5.84% 7.08% 9.71% 11.90% 9.80% 9.15% 8.85%National Health Insurance _ _ _ _ _ _ _ _Direct Charges (Public) - 1.67% 1.84% 1.91% 1.98% 3.05% _ _ _Borrowing _ _ _ _ _ _Foreign Assistance (Loans/Grants) _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ _ _
Health Expenditure % _ 5.56% 5.84% 7.08% 9.71% 11.90% 9.80% 9.15% 8.85%Public 5.56% 5.84% 7.08% 9.71% 11.90% 9.80% 9.15% 8.85%Recurrent Expenditure _ 5.21% 5.38% 6.68% 9.19% 11.35% 9.42% 8.82% 8.48%
Personal Health Services _ 0.00% 5.30% 6.60% 8.88% 11.02% 8.70% 8.16% 7.94%Personnel (Wage/Benefits) -- 2.62% 3.76% 4.37% 5.18% 4.64% 4.33% 4.34%Drugs _ 0.85% 0.81% 1.37% 2.26% 1.46% 1.51% 1.37%Other Consumables/Supplies _ 1.34% 1.34% 2.43% 2.50% 1.76% 1.65% 1.60%Energy/Utilifies _ _ _ _Maintenance _ 0.50% 0.70% 0.71% 1.08% 0.83% 0.64% 0.60%Transportation - -- -- -- 0.01% 0.01% 0.01%
Other -- 0.02% 0.02%Public Health Activities - -- -- -- 0.51% 0.48% 0.40%Medical Education 0.22% 0.25% 0.16% 0.12% 0.09%Research And Development 0.07% 0.07% 0.07% 0.08% 0.08% 0.05% 0.05% 0.04%
Capital Expenditures 0.35% 0.46% 0.41% 0.53% 0.55% 0.38% 0.33% 0.37%Construction _ _ _ _
NewRehabilitation
EquipmentVehicles
Public Reimbursements to Private Sector _ _Private Sector
Private Insurance Reimbursement _ _ _ _ _Private Expenditures _ _ _ _
TABLE 4A. CROATIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues 000 HRDIKuna 54,442 152,531 4,073,311 28,987,956 47,892,625 287,371 3,900,813 7,469,096 7,081,832Public 54,442 152,531 4,073,311 28,987,956 47,892,625 287,371 3,900,813 7,469,096 7,081,832
State Budget - - 253,336 1,445,910 4,724,300 20,196 148,279 301,904 315,505National Health Insurance 54,442 152,531 2,793,523 21,494,083 33,670,000 222,540 2,552,534 5,767,192 6,704,377Direct Charges (Public) - - 1,026,452 6,047,963 9,498,325 44,635 1,200,000 1,400,000 -Bonowing - - - - - - - - -Foreign Assistance (Loans/Grants) - - - - - - - - 61,950
Private - - - - - - - - -Private Insurance - - - - - - - - -Direct Charges (Private) - - - - 7 - - - -
Health Expenditure 000 HRD/Kuna - - 3,981,001 26,696,068 44,427,175 260,497 3,904,701 7,215,178 -Public - - 3,981,001 26,696,058 44,427,175 260,497 3,904,701 7,215,178 106,183
Recurrent Expenditure - - 3,981,001 25,558,503 43,053,904 253,596 3,891,405 7,163,738 -Personal Health Services 5,308 18,362 3,981,001 25,526,619 42,934,634 253,295 3,883,126 6,781,621 -
Personnel (Wage/Benefits) - - 1,489,194 10,426,843 14,832,058 52,877 807,870 1,810,730 -Drugs 5,308 18,362 281,717 1,713,073 3,850,000 37,025 978,270 1,832,135 -Other Consumables/Supplies - - 692,447 5,343,587 8,552,498 61,697 483,619 744,400 -EnergyUtiiities - - - - - - 99,062 150,129 -Maintenance _- - - 40,399 78,889 -TTanspofation - - - - - - - - -Other - - 1,517,643 8,043,116 15,700,078 101,696 1,473,906 2,165,338 -
Public Health Activities - - - 31,884 119,270 301 6,146 194,388 266,733Medical Education -- - - 2,133 67,476 -Research And Development _- - - - 120,253 -
Capital Expenditures _ - - 1,137,555 1,373,271 6,901 13,296 51,440 106,183Construction _ - - 586,388 559,223 3,022 7,832 22,451 52,410
New _- - - - - 7,400Rehabilitation _- - - - - 45,010
Equipment - - _ 551,167 814,041 3,879 5,464 28,989 1,279Vehicles _- - - - - - 84
Public Reimbursements to Private Sector - - _ _ - _ - -
Prvate Sector - - _ _ - _ _ _Pfivate Insurance Reimbursement - - _ _ - _ _Private Expenditures - - _ _ _ _ _ -
Expenditure Allocation 000 HRD/Kuna _- - - - 3,904,701 7,215,178 Hospitals - - - - 1,732,055 3,107,834
in-patient - - -_- -_Out-patient _- - - -_
Non-Hospitals _ _ _ _ - _ 2,172,646 4,107,344Average salary (Wages + Benefits) HRDIKuna/Month _- - -
Average For Sector _ _ - 144,000 228,000 780 2,200 3,800 -Doctors _ - 252,000 360,000 1,200 3,300 5,400 -Nurses _ _ _ 132,000 216,000 720 2,000 3,200 -
TABLE 4B. CROATIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues 000 HRDlKuna - - - 28,987,956 23,476,777 18,177 15,424 15,233Public - - - 28,987,956 23,476,777 18,177 15,424 15,233
State Budget - - - 1,445,910 2,315,833 1,277 586 616National Health Insurance - - - 21,494,083 16,504,902 14,076 10,093 11,762Direct Charges (Public) - _ 6,047,963 4,656,042 2,823 4,745 2,855Borrowing . - -_ _ .Foreign Assistance (LoanstGrants) - _ _ _ _
Private Private Insurance - _ _ - _Direct Charges (Private) - _ _ - _
Health Expenditure 000 HRD/Kuna - - - 26,696,058 21,778,027 16,477 15,439 14,716Public - - - 26,696,058 21,778,027 16,477 15,439 14,716 _
Recurrent Expenditure - - - 25,558,503 21,104,855 16,040 15,387 14,611Personal Health Services - - - 25,526,619 21,046,389 16,021 15,354 13,831 _
Personnel (Wage/Benefits) .- - 10,426,843 7,270,617 3,345 3,194 3,693Drugs - - - 1,713,073 1,887,255 2,342 3,868 3,737Other Consumables/Supplies - - - 5,343,587 4,192,401 3,902 1,912 1,518Energy/Utilities - - - - - - 392 306Maintenance - - - _ _ _ 160 161Transportabon - - - _ _ . _ _iOther - - - 8,043,116 7,696,117 6,432 5,828 4,416 -
Public Health Activities - - 31,884 58,466 19 24 396Medical Education -- - - 8 138 Research And Development -- - - 245
Capital Expenditures - _ _ 1,137,555 673j172 436 53 105Construction - _ _ 586,388 274,129 191 31 46
New -_ _ -_ _Rehabilitation -_ _ -_ _
Equipment - _ 551,167 399,043 245 22 59Vehides I _ _ _ _ _
Public Reimbursements to Private Sector - - - - - - - -Private Sector - _ _ _ _ _ _ _
Private Insurance Reimbursement - _ _ _ _ _ _Private Expenditures - _ _ _ _ _ _ _
Expenditure Allocation 000 HRDlKuna |- - - 15,439 14,716Hospitals -- - 6,849 6,339
In-patient -- - -Out-patient -- -- -_
Non-Hospitals - _ - - - - 8,591 8,377 |Average salary (Wages + Benefits) HRDlKunalMonth -- -Average For Sector - _ 144,000 111,765 49 9 8Doctors - _ _ 252,000 176,471 76 13 11Nurses _ 132,000 105,882 46 8 7 -
TABLE 4C. CROATIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues % 4.46% 4.16% 8.62% 10.50% 10.61% 8.54% 7.44% 9.04% -Public 4.46% 4.16% 8.62% 10.50% 10.61% 8.54% 7.44% 9.04% -
State Budget - - 0.54% 0.52% 1.05% 0.60% 0.28% 0.37% -National Health Insurance 4.46% 4.16% 5.91% 7.78% 7.46% 6.61% 4.87% 6.98% -Direct Charges (Public) - - 2.17% 2.19% 2.10% 1.33% 2.29% 1.69% -Borrowng Foreign Assistance (Loans/Grants) - - - - - _ _ _
Private _ _ _ _ _Private Insurance _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _
Health Expenditure % - - 8.42% 9.67% 9.84% 7.74% 7.45% 8.74%Public - - 8.42% 9.67% 9.84% 7.74% 7.45% 8.74% _Recurrent Expenditure - - 8.42% 9.26% 9.54% 7.53% 7.42% 8.67%
Personal Health Services 0.43% 0.50% 8.42% 9.24% 9.51% 7.52% 7.41% 8.21%Personnel (Wage/Benefits) - - 3.15% 3.78% 3.29% 1.57% 1.54% 2.19% _Drugs 0.43% 0.50% 0.60% 0.62% 0.85% 1.10% 1.87% 2.22%Otter ConsumableSupplies - - 1.47% 1.93% 1.89% 1.83% 0.92% 0.90%Energy/lUtilities _- - - - 0.19% 0.18%Maintenance - _ _ _ _ - 0.08% 0.10%Transportation |- - -_ . _ _Other - | 3.21% 2.91% 3.48% 3.02% 2.81% 2.62% -
Public Health Activities. . _ 0.01% 0.03% 0.01% 0.01% 0.24% -Medical Education |- - - - - 0.08% -Research And Development |- - - - - 0.15% |
Capital Expenditures - - - 0.41% 0.30% 0.20% 0.03% 0.06% -Construction _ - - 0.21% 0.12% 0.09% 0.01% 0.03%
New - _ - -_ _Rehabilitation - - - -_
Equipment - - | 0.20% 0.18% 0.12% 0.01% 0-04%Vehicles - _
Public Reimbumements to Prlvate Sector - - - - _ - _Pr*vate Sector
Private Insurance Reimbursement _ _ _ - _ _ _ _Private Expenditures m _ _
TABLE 4D. CROATIA: SOURCES OF FINANCING AND HEALTH EXPENDITURES, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995
(% Total Expenditures)Health Revenues %-- -- -- 27.57% 20.43% 25.56% 19.64% -
Public _ 27.57% 20.43% 25.56% 19.64% -
State Budget 2.72% 1 44% 0.97% 0.79% -
National Health Insurance _ _ 19.38% 15.82% 16.72% 15.16% -
Direct Charges (Public) _ 5.47% 3.17% 7.86% 3.68%Borrowing _ _ _ _Foreign Assistance (LoanslGrants) - - _ _ _ _ _
Private _ _ _ _Private Insurance _ _ _ _Direct Charges (Private) _ _ _ _ _ .
Health Expenditure % - - - - 25.57% 18.52% 25.58% 18.97%
Public _ _ 25.57% 18.52% 25.58% 18.97%Recurrent Expenditure _ _ 24.78% 18.03% 25.49% 18.84%
Personal Health Services _ _ _ 24.71% 18.01% 25.44% 17.83%Personnel (Wage/Benefits) _ _ 8.54% 3.76% 5.29% 4.76%Drugs _ 2.22% 2.63% 6.41% 4.82%Other Consumables/Supplies _ _ 4.92% 4.390% 3.17% 1.96%EnergylUtilities _ _ - 0.65% 0.39%Maintenance _ _ _ 0.26% 0.21%Transportation _- - -_-Other 9.04% 7.23% 9.66% 5.69% _
Public Health Activities _ _ _ 0.07% 0.02% 0.04% 0.51%Medical Education - -- 0.01% 0.18%Research And Development _ _
Capital Expenditures _ _ _ 0.79% 0.49% 0.09% 0.14%Construction 0.32% 0.21% 0.05% 0.06%
New -Rehabilitation _ _ _
Equipment _ _ 0.47% 0.28% 0.04% 0.08%Vehicles _ _
Public Reimbursements to Private Sector _ _
Private SectorPrivate Insurance ReimbursementPrvate Expenditures . _ _ .
TABLE 5A. CZECH REPUBLIC: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million Kc 22,881 24,748 26,305 31,114 46,678 54,918 69,262 81,136 92,060Public 22,881 24,748 26,305 31,114 46,678 54,918 69,262 81,136 92,060
State Budget 22,881 24,748 26,305 31,114 38,459 42,857 18,645 22,614 14,060National Health Insurance _ - 50,617 58,522 78,000Direct Charges (Public) _ 8,219 12,061 - - -
Borrowing _ _Foreign Assistance (Loans/Grants) _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _
Health Expenditure Million Kc 22,881 24,748 26,305 31,114 46,678 54,918 69,262 81,136 92,060Public 22,881 24,748 26,305 31,114 38,459 42,857 69,262 81,136 92,060Recurrent Expenditure 20,871 22,116 23,597 28,759 36,039 40,411 47,617 56,002 66,500
Personal Health Services 19,272 20,408 21,734 26,757 33,882 38,078 44,784 52,459 62,000Personnel (Wage/Benefits) 8,938 9,255 9,616 11,622 13,460 15,585 19,341 23,864Drugs 4,281 4,629 5,024 6,294 7,171 7,908 9,537 10,461Other Consumables/Supplies 3,017 3,118 3,216 4,183 5,060 6,970 7,624 8,537Energy/Utilities _ _ _ _ _ _ _ _Maintenance 1,924 2,236 2,524 3,022 3,538 4,720 5,301 6,591Transportation _ _ _ _ _ _ .Other 1,112 1,170 1,354 1,636 4,653 2,895 2,981 3,006 4,500
Public Health Activities 1,599 1,708 1,863 2,002 2,157 2,333 2,833 3,543 4,500 -Medical Education _ _ _ _ _ _ _Research And Development _ _ _ _ _ _ _ _
Capital Expenditures 2,010 2,632 2,708 2,355 2,420 2,446 2,894 3,509 3,197Construction _ _ _ _ _ _ _
New _Rehabilitation _
Equipment _Vehicles _ _
Public Reimbursements to Private Sector _- - - 18,751 21,625 22,363Private Sector - _ _ 8,219 12,061 - - -
Private Insurance Reimbursement _- - -_ _ _Private Expenditures - _ 8,219 12,061 _ _
Expenditure Allocation Million Kc _- -_ _ _ Hospitals _ _ _
In-patient _ _ _Out-patient _ _ _
Non-Hospitals _ _ _ _ _ _Average salary (Wages + Benefits) Kc/Month 3,026 3,095 3,170 3,286 3,792 4,644 5,817 6,600Average For Sector 2,948 3,000 3,069 3,287 3,954 4,802 6,061 7,632Doctors 4,805 4,865 5,072 5,444 6,303 7,801 10,347 13,6521Nurses 2,732 2,770 2,838 3,109 3,722 4,545 5,899 7,144
TABLE 5B. CZECH REPUBLIC: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues Million Kc - - - 31,114 31,754 31,744 34,459 36,384 38,824Public - - - 31,114 31,754 31,744 34,459 36,384 36,824
State Budget - - - 31,114 26,163 24,773 9,276 10,141 5,624National Health Insurance - - - - - - 25,183 26,243 31,200Direct Charges (Public) _ - - - 5,591 6,972 _ _Borowing _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - - -
Private _ _ _ _ _ _ _Private Insurance _ _ _ _ _ - _ _Direct Charges (Private) _ _ _ _ _ _ _ _ _
Health Expenditure Million Kc _ _ - 31,114 31,754 31,744 34,459 36,384 36,824Public _- - 31,114 26,163 24,773 34,459 36,384 36,824Recurrent Expenditure - - - 28,759 24,516 23,359 23,690 25,113 26,600
Personal Health Services - - - 26,757 23,049 22,010 22,281 23,524 24,800Personnel (Wage/Benefits) - - - 11,622 9,156 9,009 9,622 10,701 -Drugs - - - 6,294 4,878 4,571 4,745 4,691 _Other Consumables5Supplies - - - 4,183 3,442 4.029 3,793 3,828Energy/Utlities _ _ _ _ _Maintenance - - - 3,022 2,407 2,728 2,637 2,956Transportation _ _ _ _ _ _ _ _ Other - - - 1,636 3,165 1,673 1,483 1,348 1,800
Public Health Activites - - - 2,002 1,467 1,349 1,409 1,589 1,800Medical Education _ _ _ _ _ _ _Research And Development _ _ _- - - -_ _
Capital Expenditures - - - 2,355 1,646 1,414 1,440 1,574 1,279Construction - _ _
New _ _ _Rehabilitation _ _
Equipment _ _Vehicles _ _
Public Reimbursements to Private Sector - - - - - - 9,329 9,697 8,945Private Sector - - - - 5,591 6,972 - _
Private Insurance Reimbursement - - - - - - _Private Expenditures - - - - 5.591 6,972 _ _
Expenditure Allocation Million Kc - - - - - - - -Hospitals : _ _ _ _ _ _ _ l
In-patent _ _ _ _ _ _ _ lOut-patent _ _ _ _ _ _ _ l
Non-Hospitals _ _ _ _ _ _ l lAverage salary (Wages + Benefits) KctMonth - - - 3,286 2,580 2,684 2,894 2,960 -Average For Sector - - - 3,287 2,690 2,776 3,015 3,422 -Doctors - - - 5,444 4,288 4,509 5,148 6,122 -Nurses - - - 3,109 2,532 2,627 2,935 3,204 -
TABLE 5C. CZECH REPUBLIC: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues % 4.62h 4.82% 501% 5.48% 6.51% 6.94% 7.61% 7.82% 7.31%Public 4.62% 4.82% 5.01% 5.48% 6.51% 6.94% 7.61% 7.82% 7.31%
State Budget 4.62% 4.82% 5.01% 5.48% 5.37% 5.42% 2.05% 2.18% 1.12%National Health Insurance - - - - - - 5.56% 5.64% 6.19%Direct Charges (Public) - - - - 1.15% 1.52% - - -Boffowing _ _ _ - _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - - -
Private _ _ _ - _ _ _ _Private Insurance _ _ _ - _ _ _ _Direct Charges (Private) _ _ _ _ _ _
Health Expenditure % 4.62% 4.82%h 5.01% 5.48% 6.51% 6.94% 7.61% 7.82% 7.31%Public 4.62% 4.82%Ai 5.01% 5.48% 5.37% 5.42% 7.61% 7.82% 7.31%Recurrent Expenditure 4.22% 4.31% 4.50% 5.07% 5.03% 5.11% 5.23% 5.40% 5.28%
Personal Health Services 3.89% 3.98% 4.14% 4.72% 4.73% 4.81% 4.92% 5.06% 4.92%Personnel (Wage/Benefits) 1.81% 1.80% 1.83% 2.05% 1.88% 1.97% 2.12% 2.30% -Drugs 0.86% 0.90% 0.96% 1.11% 1.00% 1.00% 1.05% 1.01%Other ConsumablslSupplies 0.61% 0.61% 0.61% 0.74% 0.71% 0.88% 0.84% 0.82% -
Energy/Utilities _ _ _ _ _ _ _ _Maintenance 0.39% 0.44% 0.48% 0.53% 0.49% 0.60% 058% 0.64%Transportation - - - - - - - . _Other 0.22% 0.23% 0.26% 0.29% 0.65% 0.37% 0.33% 0.29% 0.36%
Public Health Activities 0.32% 0.33% 0.36% 0.35% 0.30% 0.29% - 0.31% 0.34% 0.36%Medical Education _ - _ _ _ _ _Research And Development _ _ _ _ _ _ _ _
Capital Expenditures 0.41% 0.51% 0.52% 0.42% 0.34% 0.31% 0.32% 0.34%A 0.25%Construction
New _ l |Rehabilitation | _ _
Equipment _ - _Vehicles _ - _ _
Public Reimbursements to Private Sector - - - _ _ 2.06% 2.08% 1.77%Private Sector _ - _ _ 1.15% 1.52' _ _
Private Insurance Reimbursement _ - _ _ _ _ - _Private Expenditures _ _ 1.15% 1.52% 0 =
TABLE 5D. CZECH REPUBLIC: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues %- - - - - 14.26% 15.48% 15.85%6 15.60%Public _ _ _ _ - 14.26% 15.48% 15.85% 15.60%
State Budget _ _ _ _ - 11.13% 4.17% 4.42% 2.38%National Health Insurance _ _ _ _ - 11.32% 11.43% 13.21%Direct Charges (Public) - - - - - 3.13% _ - -Borrowing - - - - - - - - -
Foreign Assistance (Loans/Grants) - - - - - - - - -Private - - - - - - - - -
Private Insurance - - - - - - - - -Direct Charges (Private) - - - - - - - - -
Health Expenditure % - - - - - 14.26% 15.48% 15.85% 15.60%Public - - - - - 11.13% 15.48% 15.85% 15.60%
Recurrent Expenditure - - - - - 10.49% 10.65% 10.94% 11.27%Personal Health Services - - - - 9.89% 10.01% 10.25% 10.50%
Personnel (Wage/Benefits) - - - - - 4.05% 4.32% 4.66% -Drugs - - - - - 2.05% 2.13% 2.04%Other Consumables/Supplies - - - - - 1.81% 1.70% 1.67%Energy/Utilities - - - - - - - -Maintenance - - - - - 1.23% 1.19% 1.29% _Transportation - - - - - - -- - -Other - - - - 0.75% 0.67% 0.59% 0.76%
Public Health Activities - - - - 0.61% 0.63% 0.69% 0.76%Medical Education _- - - - - - -Research And Development _ _ _ _ _ _ _
Capital Expenditures _ _ _ _ 0.64% 0.65% 0.69% 0.54%Construction _ _ _ _
NewRehabilitation
EquipmentVehicles _ _
Public Reimbursements to Private Sector _ _ _ _ . _ 4.19% 4.23% 3.79%Private Sector
Private Insurance Reimbursement _-- -_Private Expenditures _ __ _ _ _ _ __ _
TABLE 6A. FYR MACEDONIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 19891 1990 1991 1992 1993 1994 1995Health Revenues 000 Denars - - - 39,080 79,620 711,758 3,789,906 8,112,598 208,898Public - - - 39,080 79,620 711,758 3,789,906 8,112,598 208,898
State Budget _- - 444 865 73,247 380,760 970,848 208,898Natonal Health Insurance - - - 38,636 78,755 638,511 3,409,146 7,141,750 -Direct Charges (PuNic) _ _ _ _ _ _ _ _Borrowing _ _ - _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - - -
Private _ _ _ _ _ _ _ Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure 000 Denars 134 353 6,012 46,511 103,397 917,988 4,651,227 847,270 208,898Public 134 353 6,012 46,511 103,397 917,988 4,651,227 847,270 208,898
Recurrent Expenditure 134 353 6,012 46,511 102,217 907,876 4,610,605 770,249 208,898Personal Health Services 134 353 6,012 46,511 101,352 898,080 4,523,257 622,546 -
Personnel (Wage/Benefits) 71 193 3,677 23,173 48,496 422,345 2,164,327 -Drugs - - - 4,955 10,805 88,340 328,016 622,546Other Consumables/Supplies 48 122 1,216 10,011 21,517 188,644 1,043,263 -Energy/Utilifies _ _ _ _ _ _ _MaintenanceTransportation Other 15 38 1,119 8,372 20,534 198,751 987,651 - -
Public Health Activities - - - - 865 9,796 87,348 147,703 208,898Medical Education _- - - - -Research And Development _ _ _ _ _
Capital Expenditures . _ _ _ 1,180 10,112 40,622 77,021Construction _ _ _ _ 0 0 5 23 -
New _ _ l l _Rehabilitation _ _ _ _ _
Equipment _ _ _ _ 1,180 10,112 40,617 76,998 -Vehicles _ _ _ l _
Public Reimbursements to Private Sector - - - - - - - -Private Sector _ _ _ _ _ - _ _
Private Insurance Reimbursement - - - - - - - - -Private Expenditures _ _ l _ l l _ l
Expenditure Allocation 000 Denars - - - - - - - - -Hospitals
In-patient _ _ _ _ _ _ _ _Out-patient _ _ _ _ _ _ _ _
Non-Hospitals - _ - _ _ _ _ _Average salary (Wages + Benefits) DenamslMonth - - - - - - - -Average For Sector - - 960 2,040 9,684 42,000 -Doctors _ _ . _ _ _ _N urses_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
TABLE 6B. FYR MACEDONIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Heatth Revenues 000 Denars - 39,080 46,561 28,200 25,485 24,240Public - - - 39,080 46,561 28,200 25,485 24,240 _
State Budget - - - 444 506 2,902 2,560 2,901National Health Insurance - - - 38,636 46,056 25,298 22,925 21,339Direct Charges (Public) l _ l _ l _ _ Borrowing _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _
Health Expenditure 000 Denars - - - 46,511 60,468 36,370 31,277Public - - - 46,511 60,466 36,370 31,277
Recurrent Expenditure - - - 46,511 59,776 35,970 31,004 _Personal Health Services - - 46,511 59,270 35,582 30,417 _
Personnel (Wage/Benefits) - 23,173 28,360 16,733 14,554 _Drugs _ - - 4,955 6,319 3,500 2,206Other Consumables/Supplies - - 10,011 12,583 7,474 7,015 _Energy/Utilities - _MaintenanceTransportationOther _ _ 8,372 12,008 7,874 6,641 _ -
Public Health Activities _ 506 388 587 _ _Medical Education _ _ _Research And Development
Capital Expenditures _ _ 690 401 273Construction _ _ 0 0 0
New _Rehabilitation _ _
Equipment - 8 _ 690 401 273 Vehicles -_ _
Public Reimbursements to Private Sector - | _ - _Private Sector _
Private Insurance Reimbursement _Private Expenditures _
Expenditure Allocation 000 Denars _ _ _ _Hospitals
In-patientOut-patient
Non-HospitalsAverage salary (Wages + Benefits) Denars/Month _ _ l
Average For Sector _ 960 1,193 384 282DoctorsN urses__ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
TABLE 6C: FYR MACEDONIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Heaith Rewnues - - - 6.68% 8.81% 6.09% 629% 6.31% -Pubic - - - 6.68% 8.81% 6.09% 6.29% 6.31% -
State Budget - - - 0.08% 0.10% 0.63% 0.63% 0.76% -Natkonal Healh insurarce - - - 6.80% 8.71% 5.46% 5.66% 5.56% -Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing________Foreign Assistnce (LoansiGrants) - - - - - - _
Private _ _ _ _ _ _Prvate Insurance _ _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
HealKh Expenditure %- - - 7.95% 11.44% 7.86% 7.72% - -Public - | 7.95% 11.44% 7.86% 7.72% - -Recurrent Expenditure - - - 7.95% 11.31% 7.77% 7.65% - -
Personal Heath Services - - - 7.95% 11.21% 7.69% 7.51% - -Petsonnel age/Benefits) - - - 3.96% 5.36% 3.61% 3.59% - -Drugs - - - 0.85% 1.20% 0.76% 0.54% - -Oter Consumabls/Supplies - - - 1.71% 2.38% 1.51% 1.73% _EnergyUtiNties MaintenanceTransportation - - - -- ---
Other _ _ 1.43% 2.27% 1.70% 1.64% -
Public Health Activities _ _ _ - 0.10% 0.08% 0.14% _Medical Education _ _ - _Research And Deveopmnent _ _ _ _ _ _ I
Capital Expenditures - - - - 0.13% 0.09% 0.07% _Constbction _ _ _ _
NewRehabilitation _ _ _
Equipment _ _ _ _ 0.13% 0.09% 0.07% -Vehices______
Public Reimburements to Prvate Sector _ _ _ _ _ _Prvate Sector
Private Insurance Reimbursement _ _ - _ _ _Private Expenditures _ _ _ _ _
TABLE 6D. FYR MACEDONIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues %- - - - 17.35% 12.29% 11.96% 12.05% -Public - - - - 17.35% 12.29% 11.96% 12.05% _
State Budget - - - - 0.19% 1.26% 1.20% 1.44% -
National Health Insurance - - - - 17.16% 11.02% 10.76% 10.60%Direct Charges (Public) _ - - - - - - -
Borrowing - - - - - _ _ _Foreign Assistance (Loans/Grants) - - - - _ _ _ _
Private - - - - _ _ _ _Private Insurance - - - - _ _ _ _Direct Charges (Private) - - - - - - - - _
Health Expenditure % _- - - 22.53% 15.85% 14.68% -Public - - - - 22.53% 15.85% 14.68% - _
Recurrent Expenditure - - - - 22.27% 15.67% 14.55% -Personal Health Services - - - - 22.08% 15.51% 14.27% -
Personnel (Wage/Benefits) - - - - 10.57% 7.29% 6.83% -
Drugs - - - - 2.35% 1.53% 1.04% -Other Consumables/Supplies - - - - 4.69% 3.26% 3.29% -Energy/Utilities - - - - - - - -Maintenance - - - - _ _ _ _Transportation - - - - - - - _ _Other - - - - 4.47% 3.43% 3.12% _ _
Public Health Activities - - - - 0.19% 0.17% 0.28% _Medical Education _ - - - - - -
Research And Development - - - - - - - _Capital Expenditures - - - - 0.26% 0.17% 0.13% _
Construction - - - - - - -
New - - - - _ _ _Rehabilitation _ _ _ _ _ _ _
Equipment - - - - 0.26% 0.17% 0.13%Vehicles _ _ _ _ _ _ _
Public Reimbursements to Private Sector - - - - _ _ _ _Private Sector _ _ _ _
Private Insurance Reimbursement - - - - _ _Private Expenditures _ _ _ _ _ _ _
TABLE 7A. HUNGARY: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million HUF 57,679 70,407 89,833 119,153 166,391 206,773 241,648 296,359 -Public 57,679 70,407 89,833 119,153 166,391 206,773 241,648 296,359 -
State Budget 53,979 66,907 65,669 17,194 28,502 43,014 50,214 51,379 -National Health Insurance 800 1,000 19,664 96,819 130,159 151,741 175,605 223,440 -Direct Charges (Public) 2,900 2,500 4,500 5,140 7,730 12,018 15,829 21,540 -Borrowing _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) _ _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure Million HUF 57,679 70,407 89,833 119,153 166,391 193,306 241,641 296,359 -Public 57,679 70,407 89,833 119,153 166,391 193,306 241,641 296,359 -Recurrent Expenditure 52,078 63,006 82,252 108,778 151,347 174,092 224,130 278,181 -
Personal Health Services 49,399 59,330 77,452 102,542 142,584 163,372 214,834 268,460 -Personnel (Wage/Benefits) - 18,858 22,730 32,240 42,969 63,912 76,433 93,852 -Drugs 18,901 25,321 23,764 32,709 47,133 74,248 69,500 89,800 -Other Consumables/Supplies - - - - - - - - -
Energy/Utilities - 4,329 _ _ _ _ _Maintenance - 1,490 - - - - -Transportation 350 400 400 509 800 1,118 1,069 1,580Other 30,148 8,932 30,558 37,084 51,682 24,094 67,832 83,228 _
Public Health Activities 1,080 1,318 1,754 2,373 3,547 4,625 4,448 4,006 _Medical Education 902 1,645 2,151 2,854 3,911 4,403 3,902 4,450Research And Development 697 713 895 1,009 1,305 1,692 946 1,265
Capital Expenditures 5,601 7,401 7,581 10,375 15,044 19,214 17,511 18,178Construction _ _ _ _ _ - _
NewRehabilitation
EquipmentVehides
Public Reimbursements to Private Sector . _ _ _ _ _ _ _Private Sector
Private Insurance Reimbursement _ _ _ _ _ _ _ _Private Expenditures _ _ _ _ _
Expenditure Allocation Million HUF 30,148 38,229 53,288 69,324 94,651 121,111 144,265 177,080Hospitals 19,150 23,827 33,950 41,967 56,161 70,751 85,108 108,801 _
In-patient _ _ _ _ _ _ _ _Out-patient _ _ _ _ _ _
Non-Hospitals 10,998 14,402 19,338 27,357 38,490 50,360 59,157 68,279Average salary (Wages + Benefits) HUF/Month - - - - - - - -Average For Sector _ _ _ _Doctors _ _ 16,816 - _ 36,557 37,800 _Nurses _ 7,968 - 17,008 18,200 _
TABLE 7B. HUNGARY: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100) IHealth Revenues Million HUF 94,666 96,448 112,291 119,163j 123,253 126,081 118,455 121,459 -Public 94,566 96,448 112,291 119,153 123,253 126,081 118,486 121,469 -
State Budget 88,490 91,653 82,086 17,1941 21,113 26,228 24,615 21,057 -National Health Insurance 1,311 1,370 24,580 96,81 1 96,414 92,525 86,081 91,574 -Direct Charges (Public) 4,754 3,425 5,625 5,140 5,726 7,328 7,759 8,828 -Borrowing _ _ _ _ _ _ _ _Foreign Assistance (LoanstGrants) - _ _ _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ -_ _ _ _
Health Expenditur Million HUF 94,5S6 96,448 112,291 119,153 123,283 117,870 118,451 121,459 -Public 94,56| 96,448 112,291 119,153 123,263 117,870 118,481 121,459 -
Recurrent Expenditure 85,374 86,310 102,815 108,778 112,109 106,154 109,868 114,009 -Personal Health Services 80,982 81,274 96,815 102,542 105,618 99,617 105,311 110,025 -
Personnel (WagetBenefits) - 25,833 28,413 32,240 31,829 38,971 37,467 38,464 -Drugs 30,985 34,686 29,705 32,709 34,913 45,273 34,069 36,803 -Other Consumables/Supplies _ _ _ _ - _ _ _Energy/Utilities - 5,930 _ _ _ _ _ _Maintenance - 2,041 - - - - - - -
Transportation 574 548 500 509 593 682 524 648 -Other 49,423 12,236 38,198 37,084 38,283 14,691 33,251 34,110 -
Public Health Activities 1,770 1,805 2,193 2,373 2,627 2,820 2.180 1,642 -Medical Education 1,479 2,253 2,689 2,854 2,897 2,685 1.913 1,824 -Research And Development 1,143 977 1,119 1,009 967 1,032 464 518 -
Capital Expenditures 9,182 10,138 9,476 10,375 11,144 11,716 8,584 7,450 -Construction _ - _ _ _ _ _ _
New - - _ _ _ _ _ _Rehabilitation - - _ _ _ _ _ _
Equipment _ I _ _ _ _ _ _Vehides - | _ - - _ _ _
Public Reimbursements to Private Sector - - - - - - - - -Private Sector _ | _ _ _ _ _ _
Private Insurance Reimbursement _ - _ _ _ _ _ _Private Expenditures - - - - - - - - -
Expenditure Allocation Million HUF 49,423 52,368 66,610 69,324 70,112 73,848 70,718 72,574 -Hospitals 31,393 32,640 42,438 41,967 41,601 43,141 41,720 44,591 -
In-patient - - - - - - - _Out-patient - - - - - - - - -
Non-Hospitals 18,030 19,729 24,173 27,357 28,511 30,707 28,999 27,983 -Average salary (Wages + Benefits) HUFiMonth - - - - - - - - -Average For Sector _- - - - -
Doctors _ - 21,020 - | 22,291 18,529 1Nurses _ - 9,960 _ 10,371 8,922;
TABLE 7C. HUNGARY: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1996(% GDP)Health Revenues % 4.70% 4.89% 5.21% 5.70% 7.09% 7.17%o 6.90% 6.87% -Public . 4.70% 4.89% 5.21% 5.70% 7.09% 7.17%/ 6.90% 6.87% -
State Budget 4.40% 4.65% 3.81% 0.82% 1.21% 1.49% 1.43% 1.19% -
National Health Insurance 0.07% 0.07% 1.14% 4.63% 5.54% 5.26% 5.01% 5.18% -
Direct Charges (Public) 0.24% 0.17% 0.26% 0.25% 0.33% 0.42% 0.45% 0.50% -
Borrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - _ _ _ _ _
Private _ | _Private Insurance _ - _Direct Charges (Private) _ | _ _ _ _ _
Health Expenditure % 4.70% 4.89% 5.21% 5.70% 7.09% 6.700% 6.90% 6.87% -Public 4.70% 4.89% 5.21% 5.700% 7.09% 6.70% 6.90% 6.87% -Recurrent Expenditure 4.25% 4.37% 4.77% 5.21% 6.45% 6.03% 6.40% 6.45% -
Personal Health Services 4.03% 4.12% 4.50% 4.91% 6.07% 5.66% 6.13% 6.22% -Personnel (WagelBenefits) - 1.31% 1.32% 1.54% 1.83% 2.21% 2.18% 2.18% -
Drugs 1.54% 1.76% 1.38% 1.57% 2.01% 2.57% 1.98% 2.08%Other Consumables/Supplies _ - - - - - - -_Energy/Utilities - 0.30% _ _ _ _ _Maintenance - 0.10% - - - - - -Transportation 0.03% 0.03% 0.02% 0.02% 0.03% 0.04% 0.03% 0.04%Other 2.46% 0.62% 1.77% 1.77% 2.20% 0.83% 1.94% 1.93% -
Public Health Activities 0.09% 0.09% 0.10% 0.11% 0.15% 0.16% 0.13% 0.09% -
Medical Education 0.07% 0.11% 0.12% 0.14% 0.17% 0.15% 0.11% 0.10% -
Research And Development 0.06% 0.05% 0.05% 0.05% 0.06% 0.06% 0.03% 0.03% -
Capial Expenditures 0.46% 0.51% 0.44% 0.50% 0.64% 0.67% 0.50% 0.42% -
Construction _ _ _ _ _ _ _ _NewRehabilitation
EquipmentVehicles
Public Reimbursements to Private Sector _ _ _ - _ _ _Private Sector
Private Insurance Reimbursement . _ _ _ | _ _ _ _Private Expenditures _ ._ _ _ _ ___ _
TABLE 7D. HUNGARY: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues % 7.81% 7.89% 8.63% 9.98% 12.37% 11.63% 12.05% - -Public 7.81% 7.89%h 8.63% 9.98% 12.37% 11.63% 12.05% -
State Budget 7.31% 7.50%/o 6.31% 1.44% 2.12% 2.42% 2.50% -National Health Insurance 0.11% 0.11% 1.89% 8.11% 9.67% 8.53% 8.76% -
Direct Charges (Public) 0.39% 0.28% 0.43% 0.43% 0.57% 0.68% 0.79% -Borrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure % 7.81% 7.89% 8.63% 9.98% 12.37% 10.87% 12.05% - -
Public 7.81% 7.89% 8.63% 9.98%h 12.37% 10.87% 12.05% - -
Recurrent Expenditure 7.05% 7.06% 7.90% 9.11% 11.25% 9.79% 11.18% - -
Personal Health Services 6.69% 6.65% 7.44% 8.58% 10.60% 9.19% 10.72% -Personnel (WagelBenefits) 2.11% 2.18% 2.70% 3.19% 3.59% 3.81% -Drugs 2.56% 2.84% 2.28% 2.74% 3.50% 4.18% 3.47% -Other Consumables/Supplies - - - - - - - -
Energy/Utilities - 0.49% _ _ _ _ _ _Maintenance - 0.17% - - - - - -_
Transportation 0.05% 0.04% 0.04% 0.04% 0.06% 0.06% 0.05% -Other 4.08% 1.00% 2.93% 3.10% 3.84% 1.36% 3.38% -
Public Health Activities 0.15% 0.15% 0.17% 0.20% 0.26% 0.26% 0.22% -
Medical Education 0.12% 0.18% 0.21% 0.24% 0.29% 0.25% 0.19%Research And Development 0.09% 0.08% 0.09% 0.08% 0.10% 0.10% 0.05% _
Capital Expenditures 0.76% 0.83% 0.73% 0.87% 1.12% 1.08% 0.87% _Construction _ _ _ _ _ _ _
New - - - _ _ _ _Rehabilitation - - - - - - - -
Equipment _ _ _ _ _ _ _ _Vehicles _ _ _ - _ - _ _
Public Reimbursements to Private Sector - - - - - - -
Private Sector - - - - - - - -Private Insurance Reimbursement _ - - - - - - -Private Expenditures I_I __ - - -_- - I
TABLE 8A. LITHUANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing_ LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million Litas 2.90 3.14 3.49 3.88 14.34 128.36 436.93 823.30 1,133.50Public 2.90 3.14 3.49 3.88 14.34 127.72 432.34 812.58 1,133.50
State Budget 2.90 3.14 3.49 3.88 13.57 121.50 382.19 689.73 964.00National Health Insurance - - - - 0.77 6.22 50.15 122.85 169.50Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private - - - - - 0.64 4.59 10.72Private Insurance - _ _ _ _ _ _ _Direct Charges (Private) - - - - - 0.64 4.59 10.72 -
Health Expenditure Million Litas 2.90 3.14 3.49 3.88 14.34 128.36 436.93 823.30 1,133.50Public 2.90 3.14 3.49 3.88 14.34 127.73 432.34 812.58 1,133.50Recurrent Expenditure 2.46 2.70 3.02 3.57 11.65 107.50 340.43 562.95 -
Personal Health Services 2.38 2.62 2.93 3.47, 11.27 104.76 333.39 549.78 -Personnel (Wage/Benefits) - - - 1.83 7.59 45.01 165.70 320.67 -Drugs - - - 0.36 0.71 4.76 50.42 79.72 -Other Consumables/Supplies - - - 0.75 - - 30.73 50.62 -Energy/1tilities - - - - . - 27.24 24.38 -Maintenance _ - - - - - 21.20 31.60 -Transportation - - - 0.01 - - 0.46 0.50 -Other - - - 0.52 2.97 54.99 37.64 42.29 -
Public Health Activities 0.08 0.08 0.09 0.10 0.38 2.74 5.01 9.23 - 0Medical Education - - - - - - 1.63 2.90 -Research And Development - - - - - - 0.40 1.04 -
Capital Expenditures 0.44 0.44 0.47 0.31 1.92 14.00 41.76 126.79 -Construction - - - 0.16 1.07 6.95 10.55 47.59 -
New - - - 0.15 0.81 5.06 7.39 30.95 -Rehabilitation - - - 0.01 0.26 1.90 3.16 16.65 -
Equipr .-nt - - - 0.15 0.85 7.05 12.44 23.77 -Vehides - _ _ _ - _ l I
Public Reimbursements to Private Sector - - - - 0.77 6.23 50.15 122.85 169.50Private Sector - - - - - 0.64 4.59 10.72 -
Private Insurance Reimbursement _ - - - - - - -Private Expenditures - - - - - 0.64 4.59 10.72
Expenditure Allocation Million Litas 2.90 3.14 3.49 3.87 13.57 121.50 382.19 676.57Hospitals 2.21 2.48 2.69 3.23 11.11 99.88 307.66 541.49
In-patient _ _ _ _ _ _ _ _Out-patient . -_ _ _ _ _
Non-Hospitals 0.69 0.66 0.80 0.64 2.46 21.62 74.53 135.08Average salary (Wages + Benefits) Lias/Month - - - - - - -Average For SectorDoctors - _ _ _ _ _ _ _Nurses _ _ _ _
TABLE 8B. LITHUANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues Million Litas 3.42 3.75 3.93 3.88 3.33 2.41 1.75 2.18 2.31Public 3.42 3.75 3.93 3.88 3.33 2.39 1.73 2.15 2.31
State Budget 3.42 3.75 3.93 3.88 3.15 2.28 1.53 1.83 1.97National Health Insurance - - - - 0.18 0.12 0.20 0.33 0.35Direct Charges (Public) l _ _ _ _ _ _ l
Bofrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - _
Private - - - - - 0.01 0.02 0.03 -
Private Insurance _ _ _ _ _ _ _ | _Direct Charges (Private) - - - - - 0.01 0.02 0.03 -
Health Expenditure Million Litas 3A1 3.75 3.92 3.88 3.33 2.41 1.75 2.18 2.31Public 3A1 3.75 3.92 3.88 3.33 2.39 1.73 2.15 2.31Recurrent Expenditure 2.89 3.22 3.39 3.57 2.70 2.01 1.36 1.49 -
Personal Health Services 2.80 3.13 3.30 3.47 2.61 1.96 1.33 1.46 -Personnel (Wage/Benefits) - - - 1.83 1.76 0.84 0.66 0.85 -Drugs - - - 0.36 0.16 0.09 0.20 0.21 -Other Consumables/Supplies - - - 0.75 - - 0.12 0.13 -Energy/Utilites - - - _ 0.11 0.06 -Maintenance - - - - _ _ 0.08 0.08 -Transportabon - - - 0.01 - - - - -
Other - - - 0.52 0.69 1.03 0.15 0.11 -
Public Heaflth Acvites - - - 0.10 0.09 0.05 0.02 0.02 - 0Medical Education - - - - - - 0.01 0.01Research And Development _ _ _ _ _ _ _
Capital Expenditures 0.52 0.53 0.53 0.31 0.45 0.26 0.17 0.34 -Constructon - - - 0.16 0.25 0.13 0.04 0.13 -
New - - - 0.15 0.19 0.09 0.03 0.08 -Rehabilitation - - - 0.01 0.06 0.04 0.01 0.04 -
Equipment - - - 0.15 0.20 0.13 0.05 0.06 -Vehicles _ _ _ _ _ _ _ l
Public Reimbursements to Private Sector - - - - 0.18 0.12 0.20 0.33 0.35Private Sector - - - - - 0.01 0.02 0.03 -
Private Insurance Reimbursement -- - - - - - -Privat Expenditures - - - - _ 0.01 0.02 0.03
Expenditure Allocation Million Litas 3.42 3.75 3.93 3.87 3.15 2.28 1.53 1.79 _Hospitals 2.60 2.96 3.03 3.23 2.58 1.87 1.23 1.44 _
In-patient _ _ _ _ _ _ _ _Out-patient _ _ _ _ _ _ _
Non-Hospitals 0.81 0.79 0.90 0.64 0.57 0.41 0.30 0.36 Average salary (Wages + Benefits) Litas/Month - - - - - - -_Average For SectorDoctorsNurses
TABLE 8C. LITHUANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(%GDP)Healfth Revenues % 2.64% 2.66% 2.75% 2.92% 3.75% 3.79% 3.93% 4.85% 4.72%Public 2.64% 2.66% 2.75% 2.92%A 3.75% 3.77% 3.89% 4.79% 4.72%
State Budget 2.64% 2.66% 2.75% 2.92% 3.55% 3.59% 3.44% 4.06% 4.02%Nationail Health Insurance - - - - 0.20% 0.18% 0.45% 0.72% 0.71%Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private - - - - - 0.02% 0.04% 0.06%Private Insurance _ _ -Direct Charges (Private) _- - - - 0.02% 0.04% 0.06% -
Health Expenditure % 2.63% 2.66% 2.75% 2.92% 3.75% 3.79% 3.93% 4.85% 4.72%Public 2.63% 2.66% 2.75% 2.92% 3.75% 3.77% 3.89% 4.79% 4.72%Recurrent Expenditure 2.23% 2.29% 2.38% 2.69% 3.05% 3.17% 3.06% 3.32% 0.00%
Personal Health Services 2.16% 2.22% 2.31% 2.61% 2.95% 3.09% 3.00% 3.24% -Personnel (Nage/Benefits) - - - 1.38% 1.99% 1.33% 1.49% 1.89% -Drugs - - - 0.27% 0.19% 0.14% 0.45% 0.47% -Other Consumabls/Supplies - - - 0.56% - - 0.28% 0.30% -EnergyAUtlities - - - - - - 0.25% 0.14% -Maintenance - - - - - - 0.19% 0.19% -Transportation - - - 0.01% - - - - -Other - - - 0.39% 0.78% 1.62% 0.34% 0.25% -
Public Healfth Activities 0.07% 0.07% 0.07% 0.08% 0.10% 0.08% 0.05% 0.05% -Medical Education _- - - - - 0.01% 0.02%Research And Development - - - - - - - 0.01% -
Capital Expenditures 0.40% 0.37% 0.37% 0.23% 0.50% 0.41% 0.38% 0.75% -Cornstruction - - - 0.12% 0.28% 0.21% 0.09% 0.28% -
New - - - 0.11% 0.21% 0.15% 0.07% 0.18% -Rehabilitation - - - 0.01% 0.07% 0.06% 0.03% 0.10% -
Equipment - - - 0.11% 0.22% 0.21% 0.11% 0.14% -Vehicles ' _ _ - -_
Public Reimburements to Private Sector _ _ _ 0.20% 0.18% 0.45% 0.72% 0.71%Private Sector _ _ _ - - 0.02% 0.04% 0.06% -
Private Insurance Reimbursement _- -_Private Expenditures _ . 0.02Y 0.04% 0.06%
TABLE 8D. LITHUANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues % 7.07% 6.98% 7.27% 8.26% 9.62% 12.00% 11.17% 11.85% 11.34%Public 7.07% 6.98% 7.27% 8.26% 9.62% 11.94% 11.06% 11.69% 11.34%/
State Budget 7.07% 6.98% 7.27% 8.26% 9.11% 11.36% 9.77% 9.92% 9.64%National Health Insurance - - - - 0.52% 0.58% 1.28% 1.77% 1.70%
Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private - - - - - 0.06% 0.12% 0.15%
Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) - - - - - 0.06% 0.12% 0.15%
Health Expenditure % 7.07% 6.98% 7.27% 8.26% 9.62% 12.00% 11.17% 11.85% 11.34%Public 7.07% 6.98% 7.27% 8.26% 9.62% 11.94% 11.06% 11.69% 11.34%Recurrent Expenditure 5.99% 6.00% 6.29% 7.60% 7.82% 10.05% 8.71% 8.10% -
Personal Health Services 5.80% 5.82% 6.10% 7.38% 7.56% 9.79% 8.53% 7.91% -
Personnel (Wage/Benefits) -- - - 3.89% 5.09% 4.21% 4.24% 4.61% -
Drugs - - - 0.77% 0.47% 0.44% 1.29% 1.15% -
Other ConsumableslSupplies - - - 1.59% - - 0.79% 0.73% -
Energy/Utilities - - - - - - 0.70% 0.35% -
Maintenance - - - - - - 0.54% 0.45% -
Transportation - - - 0.02% - - 0.01% 0.01% -
Other - - - 1.10% 1.99% 5.14% 0.96% 0.61% -
Public Health Activities 0.19% 0.18% 0.18% 0.22% 0.26% 0.26% 0.13% 0.13% -
Medical Education - - - - - - 0.04% 0.04% -
Research And Development - - - - - - 0.01% 0.01%
Capital Expenditures 1.07% 0.98% 0.98% 0.66% 1.29% 1.31% 1.07% 1.82% -
Construction - - - 0.34% 0.72% 0.65% 0.27% 0.68% -
New - - - 0.32% 0.55% 0.47% 0.19% 0.45% -
Rehabilitation - - - 0.02% 0.17% 0.18% 0.08% 0.24% -
Equipment - - - 0.32% 0.57% 0.66% 0.32% 0.34% -
Vehicles _ _ _ _ _ _ _Public Reimbursements to Private Sector - _ _ _ 0.52% 0.58% 1.28% 1.77% 1.70%Private Sector _ _ - - 0.06% 0.12% 0.15% -
Private Insurance Reimbursement _- - - - -Private Expenditures _ _ _ - 0.06% 0.12% 0.15% -
TABLE 9A. POLAND: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Billion Zloty 734 1,225 5,882 28,497 46,910 72,582 75,892 - -Public 734 1,225 5,882 28,497 46,910 72,582 75,892 - _
State Budget 686 1,152 5,645 26,647 41,297 60,433 75,892Natonal Health Insurance _ _ _ _ _ _ _Direct Charges (Public) 48 73 237 1,850 5,613 12,149 _ _Borrowing - _ - - - _ _ -Foreign Assistance (LoanstGrants) - - - - - - - - .
Private _ _ _ _ _ _ _ Private Insurance - - - - - - - -Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure Billion Zloty 686 1,152 4,084 24,453 41,297 60,410 75,892 -Public 686 1,152 4,084 24,453 41,297 60,410 75,892 - -Recurrent Expenditure 583 984 3,614 22,555 39,241 56,374 73,099 - -
Personal Health Services - - - - 36,651 52,526 68,096 - -Personnel (Wage/Benefits) - - - - 19,223 29,511 38,409 - -Drugs - - - - 7,978 9,865 11,573 -Other ConsumablestSupplies - - - - 2,136 2,582 3,290 . .Energy/Utilites - - - - 981 1,448 1,484 _Maintenance - - - - 2,765 3,389 4,320 _Transportation - - - - - - - -Other - - 1,381 2,194 3,570 5,731 9,020 _ -
Public Health Activities - - - _ 897 1,351 1,808 - -Medical Education - - _ . 1,423 2,142 2,781 -Research And Development - - - - 270 356 414 - -
Capital Expenditures 103 168 470 1,898 2,055 4,037 2,793 - -Construction - - - - - - - -
New - - - - - - - - -Rehabilitation - - - - - - - - -
Equipment - - - - - - - - -Vehides - - - - - - - - -
Public Reimbursements to Private Sector - - - - - - - - -Private Sector - - - - - - - -
Private Insurance Reimbursement - - - - - - - - -Private Expenditures - - - - - - - - -
Expenditure Allocation Billion Zloty - - - - - - - - -Hospitals - - - - 19,504 28,071 36,520 - -
In-patient - - - - - -- - - -
Out-patient - _ _ _ _ - - _Non-Hospitals - _ _ _ _ _ - _
Average salary (Wages + Benefits) 000 Zl/Month - - - - - - - _Average For Sector 22 41 189 1,041 1,604 - - _Doctors - - - - - - - . _Nurses _ _ . . _
TABLE 9B. POLAND: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues Billion Zloty 29,350 30,631 30,009 28,497 30,265 33,759 27,008 - -
Public 29,350 30,631 30,009 28,497 30,265 33,759 27,008 _State Budget 27,440 28,800 28,763 26,647 26,643 28,108 27,008 _National Health Insurance _ _ _ _ _ _ _Direct Charges (Public) 1,910 1,831 1,245 1,850 3,622 5,651 _ _Borrowing _ _ _ - _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - -
Private _ _ _ - _ _ _ _Private Insurance _ _ _ I _ _ _ _Direct Charges (Private) _ _ _ | _ _
Health Expenditure Billion Zloty 27,440 28,800 21,495 24,453 26,643 28,098 27,008 - -
Public 27,440 28,800 21,495 24,453 26,643 28,098 27,008 - -
Recurrent Expenditure 23,320 24,600 19,021 22,555 26,317 26,220 26,014 -
Personal Health Services - - - - 23,646 24,431 24,233 -
Personnel (Wage/Benefits) _ - - - 12,402 13,726 13,669 -
Drugs - - - - 5,147 4,588 4,119 -
Other Consumables/Supplies - - - - 1,378 1,201 1,171 -
Energy/Utilities - - - - 633 673 528 -
Maintenance - - - - 1,784 1,576 1,537 -
Transportation _ _ _ I _ _ _ _Other - - 7,268 2,194 2,303 2,666 3,210 - 4.r~
Public Health Activities - - - - 579 628 644 - -
Medical Education - - | 918 996 990 - -
Research And Development - - - 174 165 147 - -
Capital Expenditures 4,120 4,200 2,474 1,898 1,326 1,878 994 - -
Construction NewRehabilitation _ _
Equipment _ _ _ _ _Vehicles _ _ _ _
Public Reimbursements to Private Sector - - - - - _ _ _Private Sector _ _ _ _ _
Private Insurance Reimbursement - - - - - _ _
Private Expenditures
Expenditure Allocation Billion Zloty _ _ - - - - -_
Hospitals - - - - 12,583 13,056 12,996 _
In-patient _ _ _ _ _ _ _ _Out-patient _ _ _ _ _ _ _ _
Non-Hospitals _ _ _ _ _ _ _ _Average salary (Wages + Benefits) 000 ZilMonth - - - - - - - - -
Average For Sector 896 1,015 997 1,041 1,035 - - - -
Docors _ _ _ _ _ _N urse _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
TABLE 9C. POLAND: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(1% GDP)HealshRevenues % 4.33% 4.14% 4.82? 5.09% 5.80% 6.31% 4.87% _Public 4.33% 4.14% 4.82% 5.09% 5.80% 6.31% 4.87% _
State Budget 4.05% 3.89% 4.62% 4.76% 5.11% 5.26% 4.87% _National Health Insurance - _ _ _ _ _Direct Charges (Public) 0.28% 0.25% 0.20% 0.33% 0.69% 1.06% _ -Borrowing .7Foreign Assistance (Loans/Grants) - - - - - - - -
Pivate _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expendture % 4.05% 3.89% 3.45% 4.36% 5.11% 5.26% 4.87r - -Public 4.05% 3.89%C 3.45% 4.36% 5.11% 5.26% 4.87% - -Recurrent Expenditure 3.44% 3.32% 3.05% 4.03% 4.85% 4.90% 4.69% - -
Personal Health Services - - - - 4.53% 4.57% 4.37% - -
Personnel (WagelBenefits) _- - 2.38% 2.57% 2.47% - -
Drugs - - - 0.99% 0.86% 0.74% - -
Other Consumables/Supplies - - - - 0.26% 0.22% 0.21% - -
Energylutiuties - - - - 0.12% 0.13% QA0% - -
Maintenance - - - - 0.34% 0.29% 0.28% - -
Transportation - - - - - - - - -Other - - 1.17% 0.39%o 0.44% 0.50% 0.58% - -
Public Health Activities - - - - 0.11% 0.12% 0.12% - -
Medical Education _ - - - 0.18% 0.19% 0.18% - -
Research And Development - - - - 0.03% 0.03% 0.03% - -
Capital Expenditures 0.61% 0.57% 0.40% 0.34% 0.25% 0.35% 0.18% - -Construction
New _ _ _ _ _ _ _ _Rehabiftation _ _ _ _ _ _ _ _
Equipment _ _ _ _ _ _ _ _Vehicles _ _ _ _ _ _ _ _
Public Reimbursements to Private Sector - - - - - - - - -
Private Sector _ _ _ _ _ _ _ _Private Insurance Reimbursement - - - - - - - - -
Private Expenditures _ _ _ _ _____
TABLE 9D. POLAND: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995
(% Total Expenditures)Health Revenues % 11.48% 11.55% 12.09% 11.67% 11.85% 12.20%E 9.75% - -
Public 11.48% 11.55% 12.090K 11.67% 11.85% 12.20% 9.75% _ _State Budget 10.74% 10.86% 11.59% 10.91% 10.43% 10.15% 9.75% _National Health Insurance _ _ _ _ _ _ _Direct Charges (Public) 0.75% 0.69% 0.50% 0.76% 1.42% 2.04% _ _Borrowing _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - _ _ _
Private _ _ _ _ _Private Insurance _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure % 10.74% 10.86% 8.66% 10.01% 10.43% 10.15% 9.75% - -
Public 10.74% 10.86% 8.66%/6 10.01% 10.43% 10.15% 9.75% - -
Recurrent Expenditure 9.13% 9.27% 7.66% 9.23% 9.91% 9.47% 9.40% - -
Personal Health Services - - - - 9.26% 8.83% 8.75% - -Personnel (Wage/Benefits) - - - - 4.86% 4.96% 4.94% - -
Drugs - - - - 2.02% 1.66% 1.49% - -Other Consumables/Supplies - - - - 0.54% 0.43% 0.42% - -
Energy/Utilities - - - - 0.25% 0.24% 0.19% - -Maintenance - - - - 0.70% 0.57% 0.56% -
Transportation - _ _ l . _ _ - _Other - - 2.93% 0.90% 0.90% 0.96% 1.16% - - o
Public Health Activities _ - - - 0.23% 0.23% 0.23% - -Medical Education _ - - - 0.36% 0.36% 0.36% - -Research And Development - - - - 0.07% 0.06% 0.05% - -
Capital Expenditures 1.61% 1.58% 1.00% 0.78% 0.52% 0.68% 0.36% - -
Construction _ _ _ - _ _ _ _New _ _ _ - _ _ _ _Rehabilitaton _ _ _ _ _ _ _ _ l
Equipment _ _ _ l _ _ _ _ l
Vehicles _ _ _ l l _ _ _ l
Public Reimbursements to Private Sector - - - - - - - - -
Private Sector _ _ _ l _ _ _ _Private Insurance Reimbursement - - - - - - - - l
Private Expenditures _ __ _ _
TABLE 10A. ROMANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 19931 1994 1995Health Revenues Million Lei 17,533 17,824 18,975 24,210 71,730 215,432 604,124 1,662,312 2,620,400Public 17,533 17,824 18,975 24,210 71,730 215,432 604,124 1,662,312 2,620,400
State Budget 17,533 17,824 18,975 24,210 62,680 152,990 468,800 1,273,340 1,852,310Nabonal Health Insurance _ _ _ _ _ _ _Direct Charges (Public) _ _ _ _ _ - _ Borrowing - - - - - 19,800 43,000 144,700 352,290Foreign Assistance (Loans/Grants) - - - - - 10,472 25,844 80,682 130,000
Private _ _ _ -_ _ _Private Insurance _ _ _ _ _Direct Charges (Private) _ _ _ - _ _
Health Expenditure Millon Lei 17,533 17,824 18,976 24,210 71,730 215,432 604,124 1,662,312 2,620,400Public 17,533 17,824 18,975 24,210 71,730 215,432 604,124 1,662,312 2,620,400Recunent Expenditure - - - 24,170 67,380 199,822 562,574 1,531,162 2,271,010
Personal Health Services - - - 24,170 67,380 199,822 562,574 1,531,162 2,271,010Personnel (Wage/Benefits) - - - 16,310 43,490 109,540 310,730 765,600 1,139,670Drugs - - - 3,110 9,310 25,450 73,440 256,590 425,830Other Consumables/Supplies - - - 2,560 7,570 19,680 56,080 143,860 188,500Energy/Utilities - - - - - - - - -Maintenance - - 1,890 6,710 20,250 60,460 167,110 211,040Transportation - - - 20 50 120 330 950 2,270Other - - - 280 250 24,782 61,534 197,052 303,700
Public Heaflth Acvities -_ - i - -Medical Education _ _ _Research And Development _ _ - -_
Capital Expenditures - - - 40 4,350 15,610 41,550 131,150 349,390Construction - - - - - - - - -
New _ _ _ _ _ - _ _Rehabilitation _
Equipment _ _ - - _ - - _Vehicles _ _ _ _ _ _ - _
Public Reimbursements to Private Sector - - - - - - , - _Private Sector _ _ _ I I I
Private Insurance Reimbursement - - - - - - - _Private Expenditures _ _ - _ _ i
Expendlture Allocation Million Lei - - - 24,210 71,730 185,160 535,280 1,436,930 2,138,110Hospitals - - - 13,690 44,520 119,030 312,410 851,340 1,371,370
In-patent - - - - - - - -Out-patient _ _ _ _ _ _ _ _
Non-Hospials - - - 10,520 27,210 66,130 222,870 585,590 766,740Average salary (Wages + Benefits) LeUMonth - - - - - - - - -
Average For Sector 2,675 2,725 2,870 3,262 7,983 19,760 55,067 145,869 -Doctors 3,694 4,029 4,029 4,029 9,396 22,480 102,240 185,560 -Nurses 2,436 2,817 2,817 2,817 6,120 14,600 68,520 124,280 -
TABLE 1OB. ROMANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995
(Deflated Expenditures, 1990=100)Health Revenues Million Lei 20,153 20,487 21,811 24,210 24,315 23,190 20,868 24,674 29,693Public 20,183 20,487 21,811 24,210 24,315 23,190 20,868 24,674 29,693
State Budget 20,153 20,487 21,811 24,210 21,247 16,468 16,193 18,901 20,989National Health Insurance . -_ _ _ _ _ _Direct Charges (Public) _ - _ _ _ _ _ _Borrowing - - - - - 2,131 1,485 2,148 3,992Foreign Assistance (Loans/Grants) _ - - - - 1,127 893 1,198 1,473
Private _ - _ _ _ _ _ _Private Insurance _ - _ _ _Direct Charges (Private) _ | _ _ _
Health Expenditure Million Lel 20,153 20,487 21,811 24,210 24,315 23,190 20,868 24,674 29,693Public 20,163 20,487 21,811 24,210 24,315 23,190 20,868 24,674 29,693Recurrent Expenditure - - - 24,170 22,841 21,509 1943 22,728 25.734
Personal Health Services - l 24,170 22,841 21,509 19,433 22,728 25,734Personnel (Wage/Benefits) - - _ 16,310 14,742 11,791 10,733 11,364 12,914Drugs - - . 3,110 3,156 2,740 2,537 3,809 4,825Other Consumables/Supplies - - - 2.560 2,566 2,118 1,937 2,135 2,136Energy/Utlities _ _ _ _ _ _ _
Maintenance - - _ 1,890 2,275 2,180 2,088 2,480 2,391Transportation . _ _ 20 17 13 11 14 26
Other i _ _ 280 85 2,668 2,126 2,925 3,44100
Public Health Activities _ _Medical Education _Research And Development _ _
Capital Expenditures - . 40 1,475 1,680 1,435 1,947 3,959
Construction _ _ _ _ _ _
New _Rehabilitation
EquipmentVehicles
Public Reimbursements to Private Sector _ .. _ _ _ .. _
Private SectorPrivate Insurance ReimbursementPrivate Expenditures _ _ _ _ _ _
Expenditure Allocation Million Lei - 24,210 24,315 19,931 18,490 21,329 24,228Hospitals _ _ 13,690 15,092 12,813 10,791 12,637 15,540
In-patientOut-patient
Non-Hospitals _ 10,520 9,224 7,118 7,698 8,692 8,688Average salary (Wages + Benefits) Lei/Month _ _ _ . ..
Average For Sector 3,075 3,132 3,299 3,262 2,706 2,127 1,902 2,165
Doctors 4,246 4,631 4,631 4,029 3,185 2,420 3,532 2,754Nurses I_______ 2,800 3,238 3,238 2,817 2,075 1,572 2,367 1,845 --
TABLE IOC. ROMANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(%/ GDP)Health Revenues % 2.07% 2.08% 2.37% 2.82% 3.25% 3.54% 3.06% 3.57% 4.04%Public 2.07% 2.08% 2.37% 2.82% 3.25% 3.54% 3.06% 3.57% 4.04%
State Budget 2.07% 2.08% 2.37% 2.82% 2.84% 2.51% 2.38% 2.73% 2.86%National Health Insurance _ _ _ _ _ _ _ _Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing - - - - - 0.33% 0.22% 0.31% 0.54%Foreign Assistance (Loans/Grants) - - - - - 0.17% 0.13% 0.17% 0.20%
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure % 2.07% 2.08% 2.37% 2.82% 3.25% 3.54% 3.06% 3.57% 4.04%Public 2.07% 2.08% 2.37% 2.82% 3.25% 3.54% 3.06% 3.57% 4.04%Recurrent Expnditure - - - 2.82% 3.06% 3.28% 2.85% 3.29% 3.50%
Personal Health Services - - - 2.82% 3.06% 3.28% 2.85% 3.29% 3.50%Personnel (Wage/Benefits) - - - 1.90% 1.97% 1.80°h 1.57% 1.64% 1.76%Drugs - - - 0.36% 0.42% 0.42% 0.37% 0.55% 0.66%Other Consumables/Supplies - - - 0.30% 0.34% 0.32% 0.28% 0.31% 0.29%Energy/Utilities _ _ _ _ _ - _ - -Maintenance - - - 0.22% 0.30% 0.33% 0.31% 0.36% 0.33%0oTransportation - - - 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% IPOther - - - 0.03% 0.01% 0.41% 0.31% 0.42% 0.47%
Public Health Activities _ _ _ _ _ _ _ _Medical Education _ _ _ _Research And Development _ _ _ _ _ _ _
Capital Expenditures - - - - 0.20% 0.26% 0.21% 0.28% 0.54%Construction _ - _ - _
New _ _ _ _ _ _ _ _Rehabilitation - - - - - - - - -
Equipment - - - - - - - -Vehicles _ _ _ - _ - _ _
Public Reimbursements to Pfivate Sector - - - - - - - - -Private Sector _ _ _ - _ - _ _
Private Insurance Reimbursement - - - - - - - - -Private Expenditures _ _ _ _
TABLE 1OD. ROMANIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues % 6.23% 6.22% 6.58% 7.79% 13.34% 13.24% 8.89% 9.81% 10.52%Public 6.23% 6.22% 6.58% 7.79% 13.34% 13.24% 8.89% 9.81% 10.52%
State Budget 6.23% 6.22% 6.58% 7.79% 11.65% 9.40% 6.90% 7.51% 7.44%National Health Insurance _ _ _ _ _ _ _Direct Charges (Public) _ _ _ _ _ _ _ _Borrowing - - - - - 1.22% 0.63% 0.85% 1.41%Foreign Assistance (LoanslGrants) - - - - - 0.64% 0.38% 0.48% 0.52%
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _Direct Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure % 6.23% 6.22% 6.58% 7.79% 13.34% 13.24% 8.89% 9.81% 10.52%Public 6.23% 6.22% 6.58% 7.79% 13.34% 13.24% 8.89% 9.81% 10.52%Recurrent Expenditure - - - - 12.53% 12.28% 8.28% 9.03% 9.12%
Personal Health Services - - - 12.53% 12.28% 8.28% 9.03% 9.12%Personnel (Wage/Benefits) - - - _ 8.09% 6.73% 4.57% 4.52% 4.57%Drugs - - - _ 1.73% 1.56% 1.08% 1.51% 1.71%Other Consumables/Supplies - - - _ 1.41% 1.21% 0.82% 0.85% 0.76%EnergylUtilities _ _ _ _ _ _ _ _Maintenance - - - _ 1.25% 1.24% 0.89% 0.99% 0.85%Transportation - - - _ 0.01% 0.01% 0.00% 0.01% 0.01% 0
Other - - - _ 0.05% 1.52% 0.91% 1.16% 1.22%Public Health Activities _ _ _ _ _ _ _ _Medical Education _Research And Development _ _ _ _ _ _ _ -
Capital Expenditures - - - _ 0.81% 0.96% 0.61% 0.77% 1.40%Construction _ _ _ - _ _
New _ _ _Rehabilitation _ _ _
Equipment _ _ _Vehicles _ _ _
Public Reimbursements to Private Sector - - _ _ _ _
Private Sector _ _Private Insurance Reimbursement - - _ _ _ _ _
Private Expenditures _ _ __ _ ___ _
TABLE 1 1A. SLOVAKIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million Sk 10,367 10,601 11,964 13,796 14,836 18,324 21,665 27,970 31,240Public 10,367 10,601 11,964 13,796 14,836 15,324 21,665 27,970 31,240
State Budget 10,367 10,601 11,964 13,796 14,644 15,324 13,655 15,820 16,240National Health Insurance - - - - - - 8,010 12,150 15,000Direct Charges (Public) _ _ _ _ 192 - - -Bonrowing _Foreign Assistance (Loaris/Grants) _ _ _ _ _ _ _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ _ _ _ _ _
Health Expenditure Million Sk 10,367 10,601 11,964 13,796 14,644 15,324 21,665 27,970 31,240Public 10,367 10,601 11,964 13,796 14,644 15,324 21,665 27,970 31,240Recurrent Expenditure 10,367 10,601 11,964 13,796 14,644 15,324 21,665 27,970 31,240
Personal Health Services 10,367 10,601 11,964 13,796 14,644 15,324 21,665 27,970 31,240Personnel (VWagelBenefits) 3,244 3,464 3,735 5,345 5,766 5,987 7,104 8,144 -Drugs Other Consumables/Supplies 3,945 4,193 4,336 5,768 5,935 6,234 7,745 8,677Energy/Utilities _ _ _ _ _ _ _ _MaintenanceTransportation _ _ _ _ _ _ _ Other 3,178 2,944 3,893 2,683 2,943 3,103 6,816 11,149 _
Public Health Activities - - - - - - - - _Medical Education _ _Research And Development _
Capital Expenditures - - 1,235 _ _ _ _ _Construction _ _ _ _ _ _ _ _
New _ _ _ _ _ _ _ _Rehabilitation _ _ _ _ _ _ _ _
Equipment _ _ _ X _ _ - _Vehides _ _ _ l - _ _ _
Public Reimbursements to Private Sector - - - - - - - _Private Sector _ _ _ l l _ l l
Private Insurance Reimbursement - - - - - - - -Private Expenditures _ _ _ _ X _ _ _
Expenditure Allocatfon Million Sk - - - - - - - -Hospitals _ _ _ l - _ _ _
In-patient _ _ _ _ _ _ _ _Out-patient _ _ _ _ _ _ _ _
Non-HospitalsAverage salary (Wages + Benefits) Sk/Month - _ _ _ _ _ _ _Average For SectorDoctorsNurses _ _ _ _ _ _
TABLE 11 B. SLOVAKIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1990=100)Health Revenues Million Sk - - 12,8S6 13,796 11,071 10,285 12,596 14,568 14,698Public - - 12,865 13,796 11,071 10,285 12,696 14,568 14,698
State Budget - - 12,865 13,796 10,928 10,285 7,939 8,240 7,589Natbonal Health Insurance _ - - - - - 4,657 6,328 7,009Direct Charges (Public) - _ _ _ 143 _- - -
Borrowing _Foreign Assistance (Loans/Grants) - - -_ _ - _ _ _
Private ' _Private Insurance _ _Direct Charges (Private) _ _
Health Expenditure Million Sk _ - 12,865 13,796 10,928 10,286 12,596 14,668 14,598Public - - 12,865 13,796 10,928 10,286 12,596 14,568 14,598Recurent Expenditure - - 12,865 13,796 10,928 10,285 12,596 14,568 14,598
Personal Health Services - - 12,865 13,796 10,928 10,285 12,596 14,568 14,598Personnel (WgeBenefits) - - 4,016 5,345 4,303 4,018 4,130 4,242 -
Drugs _ _ _ _ - _ - _Other Consumables/Supplies - - 4,662 5,768 4,429 4,184 4,503 4,519Energy/Utlities _ _ _ _ | _ _ _Maintenance _ _Transportabon _ _ _ _ _ _ _ _Other - - 4,186 2,683 2,196 2,083 3,963 5,807 _
Public Health Acdvities _ _ _ _ _ _ _ _Medical Education _ _Research And Development _ _ _
Capital Expenditures - - 1,328 _ _ _ _ _ _Constructon _
NewRehabilitation
Equipment _ _ _ _ _ _Vehiles _ _ _ _ _ _
Public Reimbursements to Private Sector _- - - - - -
Private Sector _ _ _ _ _ _Private Insurance Reimbursement - - - - - - _ _Private Expenditures _ _ _ _ _ _
Expenditure Allocation Million Sk _ _ _ _ _ _ _ _ _
HospitalsIn-patientOut-paiient
Non-HospitalsAverage salary (Wages + Benefits) SklMonth _ _ _ _ _ _ _ _Average For SectorDoctorN u rses _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _
TABLE 11C. SLOVAKIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues % 4.78% 4.46% 5.04% 5.37% 5.02% 5.08% 6.36% 7.05% 6.82%Public 4.78% 4.46% 5.04% 5.37% 5.02% 5.08% 6.36% 7.05% 6.82%
State Budget 4.78% 4.46% 5.04% 5.37% 4.95% 5.08% 4.01% 3.99% 3.54%National Healfth Insurance - - - - - - 2.35% 3.06% 3.27%Direct Charges (Public) _ _ _ _ 0.06% - - -Borrowing _Foreign Assistance (Loans/Grants) _ _ - _ _ _
PrivatePrivate InsuranceDirect Charges (Private) _ _ _ _
Health Expenditure % 4.78% 4.46% 5.04% 5.37% 4.95% 5.08% 6.36% 7.05% 6.82'Public 4.78% 4.46% 5.04% 5.37% 4.95% 5.08% 6.36% 7.05% 6.82%Recurrent Expenditure 4.78% 4.46% 5.04% 5.37% 4.95% 5.08% 6.36% 7.05% 6.82%
Personal Health Services 4.78% 4.46% 5.04% 5.37% 4.95% 5.08% 6.36% 7.05% 6.82%Personnel (Wage/Benefits) 1.50% 1.46% 1.57% 2.08% 1.95% 1.98% 2.08% 2.05% -Drugs - - - - - - - -Other Consumables/Supplies 1.82% 1.77% 1.83% 2.24% 2.01% 2.07% 2.27% 2.19%Energy/lUilities - - - - - - - -Maintenance - _ _ _ _ -_ _ _Transportation _ _ _ - _ _ _ _Other
Public Health Activities - - _ _ l _ l |Medical Education - - _ _ _ _ _ _Research And Development _ _ _
Capital Expenditures - - 0.52% _ - _ _ lConstruda7 _ - -_ _
New - - _ _ _ _ _ _ _Rehabilitation _ _ _ _ _ _ _ _
Equipment _ _ _ _ I _ I _Vehices _ _ _ _ _ _ _
Public Reimburements to Privae Sector l _ _ _ _ l lPrvate Sector - _ _ -_ -_ _ _
Private Insurance Reimbursement : -_ _ _ _ _ _ _Private Expenditures - _ : _ _ _ _ _
TABLE 11D. SLOVAKIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995
(% Total Expenditures)Health Revenues % _ - - - - 7.96% 11.43% 13.40% 13.14%Public - - - - - 7.96/ 11.43% 13.40% 13.14%/
State Budget - - - - - 7.96% 7.21% 7.58% 6.83%National Health Insurance - - - - - - 4.23% 5.82% 6.31%Direct Charges (Public) _ _ _ _Borrowing _Foreign Assistance (Loans/Grants) - _ _ _ _ _ _ _
Private _Private Insurance _Direct Charges (Private) _ -- _
Health Expenditure % - - - - - 7.96% 11.43% 13.40% 13.14%Public - - - - - 7.96% 11.43% 13.40% 13.14%Recurrent Expenditure - - - - - 7.96% 11.43% 13.40% 13.14%
Personal Health Services - - - - - 7.96% 11.43% 13.40% 13.14%Personnel (Wage/Benefits) - _ _ 3.11% 3.75% 3.90%Drugs _ _ _ _Other Consumables/Supplies - _ _ 3.24% 4.09% 4.16%Energy/Utilities _ _ --Maintenance _ _ _ _ _ _ _ -
Transportation _ _ _ _-- - - _
Other _ _ _ 1.61% 3.60% 5.34%Public Health Activities -_ .Medical EducationResearch And Development _
Capital Expenditures _Construction _
New _Rehabilitation
EquipmentVehicles
Public Reimbursements to Private Sector _ _ _ _Private Sector
Private Insurance Reimbursement _ _ _ _ _ _Private Expenditures _ _ _ _ _
TABLE 12A. SLOVENIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues Million Tolars - - 13,968 18,086 74,590 110,076 135,112 163,521Public _ - - 13,968 18,086 74,590 110,076 135,112 163,521
State Budget - - | 13,968 18,086 1,737 3,510 9,966 4,398National Health Insurance - - - - - 72,853 106,566 125,147 159,123Direct Charges (Public) _ _ _ _ _ _
Foreign Assistance (Loans/Grants) - - - - - - - - -Private Private Insurance _ - - _ _ _ - _Direct Charges (Private) _- - - - - - -
Health Expenditre Million Tolars - - - 13,968 18,086 74,590 110,076 142,056 1,922Public - i - 13,968 18,086 68,812 103,955 126,422 1,922
Recurrent Expenditure - _ _ 13,900 18,002 68,657 103,228 124,807 -Personal Health Seiices - - _ 13,444 17,481 67,971 102,361 123,770 -
Personnel (Wage/Benefits) - - _ 7,413 7,825 34,278 53,170 64,809 -Drugs - _ _ 1,989 2,447 11,871 17,313 23,242Other ConsumableslSupplies - - - 2,524 3,361 11,346 19,331 20,242 -Energy/Ublities _- - - - - - -Maintenance _ - - 204 222 1,065 1,122 1,132Transportation - - - 261 642 1,663 2,254 2,679 -Other - - - 1,054 2,983 7,748 9,171 11,666 -
Public Health Acdivities - - - 456 521 686 845 1,007 1,514Medical Education - - - - - - 14 22 29Research And Development - - - - - - 7 9 14
Capital Expenditures - - - 67 84 154 727 1,615 1,922Construction - - - - - - - - -
New - - - - - _Rehabilitation - - - - - - - - -
Equipment - - - - - 154 727 1,615 1,922Vehicles - - - - - - - - -
Public Reimbursements to Private Sector - - - - - 5,778 6,121 15,634Private Sector - - - - - - - -
Private Insurance Reimbursement - - - - -Private Expenditures - - - - - - - -
Expenditure Allocation Million Tolars - - 13,968 18,086 74,590 110,076 135,143Hospitals - - - 7,585 9,423 34,162 46,892 66,220
In-patient - - - - - - - -Out.patient -- - - - - -_
Non-Hospitals - - - 6,383 8,663 40,428 63,184 68,923AVeN ulary (Wage + Bnefits) Tolars/Month - - - 10,159 16,836 51,056 77,882 - -
Average For Sector - - - 13,210 21,280 63,983 97,012 - -Doctors - - - 21,131 31,464 97,885 146,254 - -Nurses .- - 11,571 19,708 59,999 93,730 - -
TABLE 12B. SLOVENIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995
(Deflated Expenditures, 1990=100)Health Revenues Million Tolars - - - 13,968 9,181 12,452 13,742 13,285 12,750Public . - - 13,968 9,181 12,452 13,742 13,285 12,750
State Budget - - - 13,968 9,181 290 438 980 357National Health Insurance - - - - - 12,162 13,304 12,305 12,393Direct Charges (Public) - -_ _ _ _ _ _ _Borrowing _ _ _ _ _ _ _ _Foreign Assistance (Loans/Grants) - - - - - - - - -
Private _ _ _ _ _ _ _ _Private Insurance _ _ _ _ _ _ _ _ _Direct Charges (Private) _ _ _ - _ _ _ _
Health Expenditure Million Tolars - - - 13,968 9,181 12,452 13,742 13,968 12,750Public - - - 13,968 9,181 12,452 13,742 13,968 12,750
Recurrent Expenditure - - - 13,900 9,138 11,462 12,887 12,272 _Personal Health Services - - - 13,444 8,873 11,347 12,779 12,170 _
Personnel (Wage/Benefits) - - - 7,413 3,972 5,723 6,638 6,373 _Drugs _ _ _ 1,989 1,242 1,982 2,161 2,285Other Consumables/Supplies - - - 2,524 1,706 1,894 2,413 1,990Energy/Utililies _ _ _ _ _ _ _ _Maintenance - - - 204 113 178 140 111Transportabon -- -_ 261 326 278 281 263Other - - - 1,054 1,514 1,293 1,145 1,147 - 6
Public Health Activities - - - 456 265 115 106 99 123 co
Medical Educabon - - - - _ 2 2 2
Research And Development - - - - - - 1 1 1
Capital Expenditures - - - 67 42 26 91 159 156
Construction _ _ _ _ _ _ _ _New _ _ _ _ _ _ _ _Rehabilitation _ _ _ _ _ _ _ _ _
Equipment - - - - - 26 91 159 156Vehicles _ _ _ _ _ _ _ _
Public Reimbursements to Private Sector - - - - - 965 764 1,537
Private Sector - _ _ _ _ _ _ _Private Insurance Reimbursement - _ _ _ _Private Expenditures - _ _ _ _
Expenditure Allocation Million Tolars - - - 13,968 9,181 12,452 13,742 13,288 iHospitals - - - 7,585 4,783 5,703 5,854 6,511
In-patient _ _ _ _ _ _ _ _Out-patient - _ _ _ _ _ _ _
Non-Hospitals - - - 6,383 4,397 6,749 7,888 6,777
Average salary (Wages + Benefits) Tolars/Month - - 10,159 8,546 8,524 9,723 -
Average For Sector - _ - 13,210 10,802 10,682 12,111Doctors - _ _ 21,131 15,972 16,341 18,259 _
Nurses - - - 11,571 10,003 10,017 11,702 _
TABLE 12C. SLOVENIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues %- - - 5.63% S.17% 7.42% 7.67% 7.47% 7.27%Public - - - 5.63% 5.17% 7A42% 7.67% 7.47% 7.27%
State Budget - | - 5.63% 5.17% 0.17% 0.24% 0.55% 0.20%National Health Insuranc _ _ _ - - 7.25% 7.43% 6.92% 7.07%Direct Charges (Public) -_ _BorrowingForeign Assistance (Loans/Grants) - _ _ _ _ _ . _ _
PrivatePrivate InsuranceDirect Charges (Private)
Health Expenditure % . | - 5.63% 5.17% 7.42% 7.67% 7.86% 7.27%Public --_ 5.63% 5.17% 7.42% 7.67% 7.86% 7.27%Recurrent Expenditure - . - 5.60% 5.15% 6.83% 7.19% 6.90% -
Personal Health Services _ - - 5.42%A 5.00% 6.76% 7.13% 6.85% -Personnel tageleneft) - _ 2.99%M 2.24% 3.41% 3.71% 3.56% -Drugs | _ - 0.80% 0.70%A 1.18% 1.21% 1.29% -Other ConsumablesSupplies _ _ 1.02% 0.96% 1.13% 1.35% 1.12%S -Energy/Utilities Maintenance - _ 0.08% 0.06% 0.11% 0.08% 0.06%Transportation _ _ _ 0.10%/0 0.18% 0.17% 0.16% 0.15%Other _ _ _ 0.42% 0.85% 0.77% 0.64% 0.65% _ -
Public Health Actvities _ _ _ 0.18% 0.15% 0.07% 0.06% 0.06% 0.07%Medical Education _ _ -. _ _Research And Development _ _ -_ _
Capital Expenditures _ _ | 0.03% 0.02% 0.020% 0.05% 0.09% 0.09%Construcon _ _ -_ _
NewRehabilitation _ _ _ 5
Equipment . _ _ _ - 0.02% 0.05% 0.09% 0.09%Vehides ' _ _ _
Public ReImburmements D Prvate Sectr _ _ 0.57% 0.43% 0.86%Private Sector _ _
Privae Insurance Reimbursement _ _ _ _ _ _ _Prvate Expenditures _ _ . .
TABLE 12D. SLOVENIA: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 '1989 1990 1991 1992 1993 1994 1995
(% Total Expenditures)Health Revenues % - - - 14.94% 12.60% 16.07% 16.40% 15.80% 15.68%Public - - - 14.94%A 12.60% 16.07% 16.40% 15.80% 15.68%
State Budget - - - 14.94% 12.60% 0.37% 0.52% 1.17% 0.44%National Health Insurance - - - - - 15.70% 15.88% 14.63% 15.24%Direct Charges (Public) _ _ _ _Borrowing _Foreign Assistance (Loans/Grants) - - - - _ _ _
Private _ _ _ _Private Insurance _ _ _ _Direct Charges (Private) _ _ _ _
Health Expenditure Y _ _ _ 14.94% 12.60% 16.07% 16.40% 16.61% 15.68%Public _ _ _ 14.94% 12.60% 16.07% 16.40% 16.61% 15.68%
Recurrent Expenditure _ _ _ 14.87% 12.54% 14.79% 15.38% 14.59%Personal Health Services _ _ _ 14.38% 12.18% 14.64% 15.25% 14.47%
Personnel (Wage/Benefits) _ _ _ 7.93% 5.45% 7.38% 7.92% 7.58%Drugs _ _ 2.13% 1.70% 2.56% 2.58% 2.72%Other Consumables/Supplies _ _ | 2.70% 2.34% 2.44% 2.88% 2.37%Energy/Utilities _ _ -_ _Maintenance _ _ | 0.22% 0.15% 0.23% 0.17% 0.13%Transportation _ | 0.28% 0.45% 0.36% 0.34% 0.31%Other _ _ 1.13% 2.08% 1.67% 1.37% 1.36% _
Public Health Activities _ _ 0.49% 0.36% 0.15% 0.13% 0.12% 0.15%Medical Education _ _ l _Research And Development _-- _ _ - --
Capital Expenditures _ 0.07% 0.06% 0.03% 0.11% 0.19% 0.19%Construction _ _
New l
Rehabilitation -- - - -- -
Equipment - l 0.03% 0.11% 0.19% 0.19%Vehicles l - .-----
Public Reimbursements to Private Sector _ _ 1.24% 0.91% 1.83%Private Sector _ .
Private Insurance Reimbursement -- --
Private Expenditures ___ . .
TABLE 13A. TURKMENISTAN: SOURCES OF FINANCING AND HEALTH EXPENDITURE, NOMINAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995Health Revenues 000 Manats - - - - 1,088 11,569 182,508 1,639,496 9,835,189Public - - - 1,088 11,569 182,508 1,639,496 9,835,189State Budget - - - - 1,088 11,569 182,508 1,639,496 9,835,189Nabonal Health Insurance _ _ _ _ _ _Direct Charges (Public) _ _ _Borrowing _ _ _Foreign Assistance (Loans/Grants) _ _
Private _ _Private Insurance _ _Direct Charges (Private) _ _ _ _ _ _ _
Health Expenditure 000 Manats - - _ 1,088 11,569 182,507 1,639,496 9,835,189Public _ - - - 1,088 11,569 182,507 1,639,496 9,835,189Recurrent Expenditure - _ _ 1,004 10,021 161,451 1,395,544 8,286,300
Personal Health Services _- - - 1,004 10,021 152,032 1,320,026 8,286,300Personnel (wagelbenefits) - - - - 509 5,915 100,536 814,179 3,268,186Drugs - - - - 73 503 12,123 94,594 1,641,784Other consumables/supplies - - - - 77 1,001 11,910 130,594 1,388,986Energy/utilities - - - - 279 1,410 16,032 170,352 1,860,946Maintenance - - - - 65 1,192 9,443 91,233 126,398Transportation - - - - - - 346 6,555 -Other - - - - - - 1,642 12,519 -
Public Health Activities - - - - - - 9,419 39,055 -Medical Educaton - - - - - - - - -Research And Development - - - - - - - 36,463 -
Capital Expenditures - - - - 84 1,548 21,056 243,952 1,548,889Constructon _ _ _ _ _ _ _ _ l
New _ _ _ _Rehabilitation _ _ _ _ _ _ _ l
Equipment - - - - 18 878 7,763 45,766 139,789Vehicles _ _ _ _ _ _ _ _ l
Public Reimbursement to Private Sector - - - - - - - _ l
Private _ _ _ _ _ _ _Private Insurance Reimbursement - - - - - - -Private Expenditures _ _
Expenditure Allocation 000 Manats _ - - - - - 182,507 1,639,496Hospitals - - - - - 120,555 1,005,570 l
In-patient _ _ _ _ _ _Out-patient _ _ _ _ _
Non-Hospitals - - - - - _ 61,952 633,926Average salary (wages + benefits) Manats/Month - - - - -Average for Sector _ _Doctors _ l
Nurses I I _ _ _ _
TABLE 13B. TURKMENISTAN: SOURCES OF FINANCING AND HEALTH EXPENDITURE, REAL VALUES
Health Financing LCU 1987 1988 1989 1990 1991 1992 1993 1994 1995(Deflated Expenditures, 1991=100)Health Revenues 000 Manats - - - - 1,087.79 572.26 506.76 220.52 321.94Public _ _ _ - 1,087.79 572.26 606.76 220.52 321.94State Budget _ _ _ - 1,087.79 572.26 508.76 220.52 321.94National Health Insurance _ _ _ _ _ _ _Direct Charges (Public) _ _ _ _ _ _ _ Borrowing _ _ _ _ _ _ _ - _Foreign Assistance (Loans/Grants) - - - - - - - -
Private _ _ _ - _ _ _ Prvate Insurance _ _ _ _ _ _ _ - _Direct Charges (Private) _ _ _ | _ _ _
Health Expenditure 000 Manats - - - - 1,087.79 572.26 506.76 220.52 321.94Public - - - - 1,087.79 572.26 506.76 220.52 321.94
Recurrent Expenditure - - - - 1,003.83 495.69 448.30 187.70 271.24Personal Health Services - - - - 1,003.83 495.69 422.14 177.55 271.24
Personnel (wage/benefits) - - - - 508.70 292.58 279.16 109.51 106.98Drugs - - - - 73.31 24.88 33.66 12.72 53.74Other consumables/supplies - - - - 77.14 49.53 33.07 17.57 45.47Energy/ufilities - - - - 279.22 69.76 44.52 22.91 .60.91Maintenance - - - - 65.45 58.94 26.22 12.27 4.14Transportation - - - - - - 0.96 0.88 -Other - - - - - - 4.56 1.68 _
Public Health Activities - - - - - - 26.15 5.25 _Medical Education _ _ _ | _ _ _Research And Development - - - - - - - 4.90 -
Capital Expenditures - - - - 83.97 76.58 58.47 32.81 50.70Construction _ _ _ - _ - _
New _ _ _ _Rehabilitation - _ _ _ _ - _ _
Equipment - - - - 18.37 43.43 21.56 6.16 4.58Vehicles - - - - - - - - -
Public Reimbursement to Private Sector - - - - - - - - -Private - - - - - - - - -
Private Insurance Reimbursement - - - - - - - - -Private Expenditures | _ _- - - - -
Expenditure Allocation 000 Manats - - - - - - 506.76 220.52 -Hospitals - - - - - - 334.74 135.25 -
In-patient I _ _ - _ I _ _Out-paabent - - - - - - - -
Non-Hospitals - - - - - - 172.02 85.26 -Average salary (wages + benefits) ManatslMonth - - - - - - - - -Average for Sector - - - - - -Doctors _ _ _Nurses- ---- --
TABLE 13C. TURKMENISTAN: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % GDP
Health Financing UNITS 1987 1988 1989 1990 1991 1992 1993 1994 1995(% GDP)Health Revenues - - - - - 3.20% 1.77% 1.65% 0.800% 1.46%Public - - - - 3.20% 1.77% 1.65% 0.80% 1.46%State Budget - - - - 3.20Yo 1.77% 1.65% 0.80% 1.46%National Health Insurance _- - - - - - -Direct Charges (Public) - - - - - - - - -Borrowing - - - - - - - -Foreign Assistance (Loans/Grants) - - - - - - - - -
Private _ _ _ - _ _ _ _Private InsuranceDirect Charges (Private) _ -_ -_
Health Expenditure % _ |- -_ 3.20% 1.77% 1.65% 0.80% 1.46%Public _- - 3.20% 1.77% 1.65% 0.80% 1.46%Recurrent Expenditure - _ - - 2.95% 1.53% 1.46% 0.68% 1.23%
Personal Health Services _ _ _ - 2.95% 1.53% 1.38% 0.64% 1.23%Personnel (wage/benefits) _ _ _ 1.50% 0.91% 0.91% 0.40% 0.48%Drugs _ _ _ | 0.22% 0.08% 0.11% 0.05% 0.24%Other consumables/supplies _ _ - - 0.23%o 0.15% 0.11% 0.06% 0.21%Energy/ulities - _ _ _ 0.82% 0.22% 0.15% 0.08% 0.28%Maintenance _ _ _ - 0.19% 0.18% 0.09% 0.04% 0.02%Transportation _ _ Other _ _ _ - . - 0.01% 0.01% _
Public Health Activities _- 0.090_0 0.02%Medical Education _- -_Research And Development _ _ _ | _
Capital Expenditures _ _ _ | 0.25% 0.24% 0.19% 0.12% 0.23%Construction _ _ _ l _
NewRehabilitation _ _ _ l _
Equipment _ _ _ | 0.05% 0.13% 0.07% 0.02% 0.02%Vehides - _
Public Reimbursement to Private Sector _ _ _ - _ _ -_Private
Private Insurance Reimbursement _ _ _ _ _ _ _ _Private Expenditures ___ _ . _ _ _
TABLE 13D. TURKMENISTAN: SOURCES OF FINANCING AND HEALTH EXPENDITURE, % TOTAL EXPENDITURES
Health Financing Units 1987 1988 1989 1990 1991 1992 1993 1994 1995(% Total Expenditures)Health Revenues % - - - 5.44% 3.06%h 8.40% 10.72Ib 7.67%Public - - - - 5.44% 3.06% 8.40% 10.72% 7.67%
State Budget - - - - 5.44% 3.06% 8.40% 10.72% 7.67%National Health Insurance - - - - - - - - -Direct Charges (Public) - - - - - - - - -Borrowing - - - - - - - - -Foreign Assistance (Loans/Grants) - - - - - - - - -
Private - - - - - - - - -Private Insurance - - - - - - - - -Direct Charges (Private) - - - - - - - - -
Health Expenditure % - - - - 5.44% 3.06% 8.40% 10.72% 7.67%Public - - - - 5.44% 3.06% 8.40% 10.72% 7.67%
Recurrent Expenditure - - - - 5.02% 2.65% 7.43% 9.13% 6.46%Personal Health Services - - - - 5.02% 2.65% 7.00% 8.63% 6.46%
Personnel (wage/benefits) - - - - 2.54% 1.56% 4.63% 5.33% 2.55%Drugs - - - - 0.37% 0.13% 0.56% 0.62% 1.28%Other consumables/supplies - - - - 0.39% 0.26% 0.55% 0.85% 1.08%Energy/utilities - - - - 1.40% 0.37% 0.74% 1.11% 1.45%Maintenance - - - - 0.33% 0.32% 0.43% 0.60% 0.10%Transportation - - - - - - 0.02% 0.04% -Other - - - - - - 0.08% 0.08% _
Public Health Activities - - - - - - 0.43% 0.26%Medical Education - - - - - - - -Research And Development - - - - - - - 0.24% -
Capital Expenditures - - - - 0.42% 0.41% 0.97% 1.60% 1.21%Construction _ _ _ _ _ _ _
New _ _ _ _Rehabilitation - - - - - - -
Equipment - - - - 0.09% 0.23% 0.36% 0.30% 0.11%Vehicles - - - - - - - - -
Public Reimbursement to Private Sector - - - - _ _ _Private _ _
Private Insurance Reimbursement _- -_ _ _ _ Private Expenditures II _ __ __ _ _ _ __ __ ___ __ _-_-_
--63-
Section III: Health Status and Services
Health status and service indicators were generally obtained from the WHO. The followingbriefly describes the categories of indicators contained in the database.
(i) Lifestvyle. Indicators such as annual cigarette and alcohol consumption and diseases such astuberculosis, hepatitis and gonorrhea are included in this category. Other indicators in this categoryinclude Standardized Death Rates (SDRs) due to "car accidents," "fatalities-work accidents" and "SDRsuicide + self injury" per 100,000 population, nutritional indicators, such as percentage of total energyfrom fat, protein and alcohol, and percentage of neonates weighing more than 2500 grams.
(ii) Healthy Environment. Indicators such as the percentage of the population with access to sewagedisposal and the percentage of the population with water supply at home, for both the urban and ruralareas, are included in this category.
(iii) Appropriate Care. This category deals with the coverage, availability and quality of health serviceswithin a given country. The indicators are medical personnel, medical graduates, and number of healthunits, such as primary health care units, per 100,000 population. Other indicators include childimmunization rates, as well as abortions per 100,000 live births, inpatient admissions and average lengthof stay, and other miscellaneous categories such as SDR for drug reactions.
(iv! Health Status. This category includes incidence of specified diseases, such as diphtheria, measles,malaria and tetanus. Other indicators in this category are life expectancy at different ages, infantmortality rate, maternal mortality ratio, crude birth rate, crude death rate, total fertility rates, and SDRsper 100,000 population for groups of diseases.
�17
TABLE 14A. ALBANIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Ufestyles
Incidence Tubercukl 00,000 40,301 29.10 23.90 21.70 19.90 - 7.40 8.80 - -Incidence Hepati8s/100,000 40,310 - 318.30 297.80 341.40 - 143.40 171.40 _Incidence Gonorrhea/100,000 40,322 - _ _ 4.00 - 3.10 4.30 _SDR CarAccidents/100,000 110,201 10.30 10.30 12.60 - - 14.00 - _Fatalities-Work Accidents/1 00,000 110,503 _- - - -SDR Suicide+Self Injuryl100,000 120,101 2.40 2.40 2.50 - - 1.70 _Nutrition
% Of Total Energy From Fat 160,306 20.10% 20.60% 20.90% 20.80% 21.60% 21.00% _ _ _% Of Total Energy From Protein 160,307 11.80% 11.90% 11.90% 12.10% 12.90% 12.50% 0 _% Of Total Energy From Acohol 160.308 5.00% 0.60% 0.60% 0.50% - _ | _
% Neonates Weighing More Than 2500g 160,401 92.00% 93.10% 93.10% 93.10% _ _ _ _Annual Liters Alcohol/Person 170.101 - - - - - - _ _Annual Cigarette Consumption/Person 170,902 763.10 788.00 812.60 821.50 - 846.40 - _Nonsmokers In Population (%) 171,001 - - - - - 70.00% | _
Healthy Environnment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 _ _ _ _ _ - | _ _Urban 200,108 - - - - - - - - -Rural 200,109 - - - - - - - - -
% PopulaUon With Water Supply In Home >Total 992,001 - - - - - - - - -Urban 992,002 - - - - - - - - -Rural 992,003 _ _ _ _ _ _ _ _
TABLE 14B. ALBANIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 - - 139.60 135.90 140.00 - 140.00 130.00 -Qualified nurses 270,202 - - - - -Dentists 270,203 - | 34.30 33.40 _ _ . _ _Pharmacists 270,204 55.70 - -_ _ _ | _Midwives 270,209 - - _ _ _ _ | _
% Doctors Working In Hospitals 270,321 - - _ _ _ _ | _% Nurses Working In Hospitals 270,322 _ - -_ , _ _
Graduating Per 100,000 PopulationDoctors 360,301 - _ 5.40 _ _ _ _ _Nurses 360,302 _ - -_ _ _ _ _ Dentists 360,303 - _ 1.60 _ _ _ _ _Pharmacists 360,304 - _ 0.50 _ _ - _ _Midwives 360,305 _ - -_ _ _ _ _
Heafth UnitsPrimary Care Units/100,000 Population 270,206 _ - -_ _ _ _ _ Hospitals/100,000 Population 270,210 - _ 5.00 4.90 - 4.10 - -
Inpatient Beds/100,000 population 992,710 _ - - 4.00 4.00 4.00 3.60 3.00Psychiatric Beds/100,000 Population 992,711 - --- - - - --
Nursing Home Beds/100,000 Population 992,712 - | _ _ _ _ _ _
Utilization 9"% Children Immunized Against:
Diptheria 280,101 - - - - - - - 96.30% -
Tetanus 280,102 - - - - - - - 96.30% -
Pertussis 280,103 - - - - - - - 96.30% -
Measles 280,104 - - - - - - - 81.20% -
Polio 280,105 - - - - - - - 87.20% -
Tuberculosis 280,106 - - - - - - - 81.20% -Abortions/1,000 Live Births 280,500 - - - - - - - - -
Ambulatory Care Contacts/Person 992,801 - - - - - - - _Inpatient Admissions/1 00 Population 992,902 - - - - - - - -
Average Length Of Stay (Days) 992,901 - - - 13.40 13.70 12.70 9.00 9.00
QualitySDR Appendicitis/100,000 Population 310,304 0.20 0.30 0.30 - - 0.30 _ _SDR Drug Reactionsl100,000 Population 310,306 _ 0.00 _ _ _ _ _ _Surgical Wound Infection Rate 310,701 -_ - _ _ _ _ _
TABLE 14C. ALBANIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Reos 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 0.00 0.00 4251.60 13.00 - 0.00 0.20 0.30 -Malaria 50,112 - 0.00 0.00 0.00 - 0.00 0.00 0.00 -Diphtheria 50,113 0.10 0.10 0.20 0.50 - 1.50 0.50 0.40 -Tetanus 50,114 0.20 0.20 0.10 0.40 - 0.20 0.50 0.40 -Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 _ 0.00 0.00 0.00 -Neonatal Tetanus 50,118 0.00 0.00 0.00 0.00 - 0.00 0.00 0.00 -Rubella 50,130 0.00 0.00 - 0.00 3.30 - -Mumps 50,131 108.50 56.30 18.70 79.00 - 31.30 123.70 89.40 -Clinically Diagnosed AIDS 50,312 0.00 0.00 0.00 0.00 - 0.00 0.00 - -
Life ExpectancyAt Birth, In Years 60,101 72.30 72.60 72.10 72.60 - 73.20 73.70 _At Age 1, In Years 60,201 73.60 73.70 73.40 73.60 - 74.70 - - -AtAge 15, In Years 60,202 61.10 61.10 60.90 61.10 - 62.00 - - -At Age 45, In Years ' 60,203 32.40 32.40 32.30 32.50 - 33.60 - - -At Age 65, In years 60,204 15.40 15.30 15.20 15.30 - 16.50 - -Probabiity Of Dying Before 5 yrs 11,000 Population 60,401 46.80 42.70 45.60 42.20 - 45.20 - - -
Infant Mortality/1,000 Live Births 70,100 30.90 28.30 30.90 - - 33.80 33.40 35.70 -Matemal Deaths/100,000 Live Births 80,100 38.90 34.90 45.60 31.00 20.70 22.50 22.60 - -
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 444.90 126.80 118.00 - - 95.30 - _ _Malignant Neoplasms, All Ages 100,102 113.30 126.80 118.00 -| 95.30 | _All Causes, All Ages 990,102 - - - - - - - - -InfectiouslParasitk, All Ages 993,002 - - - - - - - - -Respiratory System, All Ages 993,202 - - - - - - - - -MentalUNervous/Sensory, All Ages 993,702 - - - - - - - - -
Crude Birth Rate (Per 1,000 Population) 998,004 25.30 25.30 24.60 25.00 - 23.60 22.44 22.30 -Crude Death Rate (Per 1,000 Population) 998,005 5.50 5.40 5.70 5.50 - 5.40 5.25 - -Total Fertility Rate 998,006 - - - 3.10 - 2.90 2.75 2.60 -
TABLE 15A. BULGARIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
LIfestyles
Incidence Tuberculosis/100,000 40,301 26.20 26.60 25.60 25.10 28.60 36.30 38.00 - -Incidence Hepatitis/100,000 40,310 87.90 122.40 107.00 267.60 260.80 143.00 113.90 _Incidence Gonorrhea/100,000 40,322 - - - - - - - _ _SDR CarAccidentsW100,000 110,201 12.20 11.70 12.90 15.50 10.10 12.30 _ _Fatalities-Work Accidentsll 00,000 110,503 - - - - - - - - -
SDR Suicide+Self Injuryl100,000 120.101 16.00 15.60 15.60 14.10 14.60 16.60 - - -Nutrition
% Of Total Energy From Fat 160,306 29.90% 30.10%/o 30.60% 3.13% 30.60% 32.30% - - -% Of Total Energy From Protein 160,307 12.00% 12.00% 11.90% 12.00% 12.10% 11.90% - - -% Of Total Energy From Alcohol 160,308 6.10% 6.20% 6.10% 6.00% - - - - -
% Neonates Weighing More Than 2500g 160,401 - - 93.70% - - - - - -Annual Liters AlcoholPerson 170,101 8.90 9.10 9.30 9.30 7.80 - - -Annual Cigarette Consumption/Person 170,902 1783.40 1532.90 1557.40 1356.90 1750.80 3729.80 2341.90 - -Nonsmokers In Population (%) 171,001 - - 67.00% - - - - - -
Healfthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - - 98.60% - - - _ _Urban 200,108 - - 100.00% - - - _ _ _Rural 200,109 - - 96.00% - - - _ _ _
% Population With Water Supply In HomeTotal 992,001 - - - - - - _ _Urban 992,002 - - - - - - _ _Rural 992,0031 - - - - -_ -
TABLE 15B. BULGARIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 302.10 309.00 313.90 317.00 298.00 319.00 336.00 335.00Qualified nurses 270,202 584.20 592.40 591.00 598.50 563.00 593.00 615.00 590.00Dentists 270,203 66.00 66.30 67.30 67.90 66.00 67.00 68.00 65.00Pharmacists 270,204 46.20 47.80 47.40 48.60 36.00 31.00 28.00 25.00Midwives 270,209 85.20 86.30 83.10 84.00 81.00 83.00 82.00 75.00
% Doctors Working In Hospitals 270,321 - - - - - - - -% Nurses Working In Hospitals 270,322 _- - - -_
Graduating Per 100,000 PopulationDoctors 360,301 7.10 - 14.60 - - - 12.50 -Nurses 360,302 - - 15.90 24.30 26.60 34.20 22.70 36.50Denbsts 360,303 2.20 - 2.00 - - - - -Pharmacists 360,304 0.80 - 1.20 _ _ _ _ _Midwives 360,305 - - 2.50 - - - - -
Healh UnitsPrimary Care Units/100,000 Population 270,206 75.40 76.30 77.10 77.60 78.20 78.80 79.50 80.10Hospitalsl100,000 Population 270,210 2.10 2.20 2.20 2.30 2.30 2.50 2.70 2.60Inpatient Bedsl100,000 population 992,710 - - - 978.00 981.00 1022.00 0.54 1022.00Psychiatric Beds/I00,000 Populaton 992,711 87.00 86.00 87.00 90.00 88.00 90.00 94.00 96.00 -Nursing Home Beds}100,000 Population 992,712 - - - - - - - - -
Utilization x% Children Immunized Against:
Diptheria 280,101 100.00% 99.00% 99.00% 99.00% 99.30% 98.30% - - -Tetanus 280,102 100.00% 99.00% 99.00% 99.00% 99.30% 98.30% - - -Pertussis 280,103 100.00% 99.00% 99.00% 99.00% 99.30% 97.10% - - -Measles 280,104 100.00% 99.00% 99.00% 98.00% 97.80% 92.20%/ - - -Polio 280,105 100.00% 99.00% 99.00% 99.00% 98.90% 98.70% - - -Tuberculosis 280,106 100.00% 99.00% 99.00% 99.00% 99.60% 99.30% - - -
Abortions/1,000 Live Births 280,500 1149.30 1133.70 988.90 1367.20 1434.20 1480.00 1264.00 1336.00 -Ambulatory Care ContactslPerson 992,801 7.50 7.40 7.20 6.60 5.60 5.80 5.50 5.50 -Inpatient Admissions/100 Population 992,902 20.40 20.50 19.80 19.60 18.70 19.10 18.60 18.20 -Average Length Of Stay (Days) 992,901 14.00 13.90 13.80 13.70 13.90 13.80 13.80 14.10 -
QualitySDR Appendicitisl100,000 Population 310,304 - - - - - - - _SDR Drug Reactions/100,000 Population 310,306 _ _ _ _ _ _ _ _Surgical Wound Infection Rate 310,701 _ _ _ _ _ _ _ _
TABLE 15C. BULGARIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 17.40 4.50 1.20 1.70 22.60 237.20 4.20 - -Malaria 50,112 - 0.00 0.00 - - - - - -Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -Tetanus 50,114 0.10 0.00 0.10 0.10 0.10 0.10 0.10 - -Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 0.50 0.00 0.00 - -Neonatal Tetanus 50,118 0.00 0.00 0.00 0.00 0.00 0.00 - -Rubella 50,130 159.90 275.20 137.80 142.40 103.50 127.50 138.70 - -Mumps 50,131 374.80 5.00 1.20 1.50 1.40 3.20 2.30 - -Clinically Diagnosed AIDS 50,312 0.00 0.00 0.10 0.00 0.00 0.10 0.10 - -
Life ExpectancyAt Birth, In Years 60,101 71.30 71.40 71.30 71.30 71.20 70.90 71.20 70.90 -AtAge 1, In Years 60,201 71.40 71.30 71.50 71.50 71.60 71.30 - - -At Age 15, In Years 60,202 57.90 57.90 58.00 58.00 58.10 57.80 - - -At Age 45, In Years 60,203 29.70 29.70 29.80 29.90 29.90 29.80 - - -At Age 65, In years 60,204 13.80 13.90 14.00 14.10 14.10 14.20 - - -Probability Of Dying Before 5 yrs /1,000 Population 60,401 18.60 17.70 18.10 18.30 20.70 20.00 - - -
Infant Mortality/1,000 Live Births 70,100 14.70 13.60 14.40 14.80 16.90 15.90 15.50 16.30 -
Matemal Deaths/100,000 Uve Births 80,100 19.70 9.40 18.70 20.90 10.40 21.30 20.10 - -
Standard Death Rates Per 100,000 Population -.1Circulatory, All Ages 90,102 714.30 702.40 694.30 691.40 699.20 677.90 - _ _Malignant Neoplasms, All Ages 100,102 156.10 155.40 156.40 152.40 155.40 158.40 _ _All Causes, All Ages 990,102 - - - - - - - _Infectious/Parasitic, All Ages 993,002 - - - - - - - _Respiratory System, All Ages 993,202 - - - - - - - _MentalNervous/Sensory, All Ages 993,702 - - - - - - - _
Crude Birth Rate (Per 1,000 Population) 998,004 13.00 13.10 12.50 11.70 10.70 10.40 10.00 9.40Crude Death Rate (Per 1,000 Population) 998,005 12.00 12.00 11.90 12.10 12.30 12.60 12.90 13.20Total Fertility Rate 998,006 - - 1.90 1.90 1.80 1.50 1.50 1.401
TABLE 16A. CROATIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Ref 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 70.90 63.20 60.70 54.50 45.10 46.10 43.20 - -Incidence Hepatifisl100,000 40,310 94.01 73.16 41.07 33.92 38.28 22.96 25.19 - -Incidence Gonorrhea/100,000 40,322 15.83 11.09 9.52 8.30 6.68 4.41 3.39 - -SDR Car Accidents/100,000 110,201 39.02 38.92 38.04 41.15 38.31 36.31 30.34 - -Fataliffes-Work Accidents/100,000 110,503 2.70 2.20 1.80 1.40 4.10 4.20 1.50 - -SDR Suicide+Self InjuryI100,000 120,101 - - - - - - - - -
Nutrition% Of Total Energy From Fat 160,306 39.00% 41.00% 36.00% 38.00% 38.00% _ _ _% Of Total Energy From Protein 160,307 12.00% 12.00% 12.00% 12.00% - _ _ _% Of Total Energy From Alcohol 160,308 _- - - - -
% Neonates Weighing More Than 25009 160,401 - - - 93.90% _ 92.50% _ _Annual LitersAlcoholPerson 170,101 _- - - - -
Annual Cigarette ConsumptionlPerson 170,902 - - - _ _ _ _ _Nonsmokers In Population (%) 171,001 - - - _ _ _ _ _
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 67.50% 67.70% 67.90% 68.10% 68.10% 68.10% 68.70% _Urban 200,108 71.80% 71.90% 72.00% 72.10% 72.10% 72.10% 73.30% _Rural 200,109 27.50% 27.70% 28.00% 28.30% 28.30% 28.30% 29.10% _
% Population With Water Supply In HomeTotal 992,001 - - - - - - - _Urban 992,002 1 _ _ _ _ _ _ _Rural 992,003 _ _ _ _ _ _ _ _
TABLE 16B. CROTIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 209.50 212.67 217.14 212.83 194.26 197.53 194.18 200.00 -Qualified nurses 270,202 485.20 494.30 504.50 511.10 454.20 447.80 441.20 - -Dentists 270,203 47.69 48.77 48.79 47.42 42.43 42.49 40.59 - -
Pharmacists 270,204 39.58 40.33 40.26 38.93 36.10 36.53 35.59 -Midwives 270,209 51.75 48.49 45.14 40.94 29.46 23.55 18.60 - -
% Doctors Working In Hospitals 270,321 43.70% 43.54% 44.25% 44.10% 40.71% 41.88% 42.23% -% Nurses Working In Hospitals 270,322 - - - - - - - -
Graduating Per 100,000 PopulationDoctors 360,301 - - - 11.80 7.37 11.33 8.52 -Nurses 360,302 - - - - - - - -
Dentists 360,303 - - - 1.97 2.23 2.74 2.34 -
Pharmacists 360,304 - - - 1.80 1.55 1.55 1.74 -
Midwvives 360,305 - - - - - - - -
Health UnitsPrimary Care Unitsl100,000 Population 270,206 - - - - - - - -
Hospitals/100,000 Population 270,210 2.35 2.31 2.31 2.18 2.11 2.05 1.99 -
Inpatient Beds/100,000 population 992,710 - - - 740.00 650.00 630.00 610.00 590Psychiatric Bedsl100,000 Population 992.711 82.48 82.35 81.77 80.02 79.22 78.00 78.15 -
Nursing Home Beds/100,000 Population 992,712 - - - - - - - - -
Utilization% Children Immunized Against
Diptheria 280,101 80.70% 83.70% 86.40% 87.90% 84.90% 82.80% 83.50% - -Tetanus 280,102 - - - - 85.00% 86.40% 88.30% - -
Pertussis 280,103 - - - - 85.00% 86.40% 88.30% - -
Measles 280,104 90.00% 91.40% 92.80% 91.50% 88.70% 89.80% 90.10% - -
Polio 280,105 82.30% 84.20% 85.20% 86.60% 85.50% 84.90% 85.30% - -Tuberculosis 280,106 93.30% 94.90% 94.70% 93.50% 92.70% 92.00% 92.10% - -
Abortions/1,000 Live Births 280,500 - - - - - - - - -
Ambulatory Care Contacts/Person 992,801 - - - - - - - - -
Inpatient Admissionsl100 Population 992,902 15.48 15.62 15.45 15.37 14.40 15.20 14.50 13.83 -Average Length Of Stay (Days) 992,901 - - - - - - - - -
QualitySDR Appendicitis/100,000 Population 310,304 _ _ _ _ _ _ _ _SDR Drug Reactions/100,000 Population 310,306 _ _ _ _ _ _ _ _Surgical Wound Infection Rate 310,701 _ _ _ _ _ _ _ _
TABLE 16C. CROATIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Stats HFA Rels 1987 1988 1989 1990 1991 1992 1993 1994 1996
Incidence, Cases Per 100,000 PopulatfonMeasles 50,111 18.60 22.60 24.00 2.50 2.40 3.40 1.90 - -Malaria 50,112 0.21 0.32 0.34 0.29 0.29 0.17 0.38 - -Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -Tebnus 50,114 0.49 0.51 0.28 0.46 0.35 0.17 0.23 - -Acute Poliomyelitis 50,015 0.00 0.00 0.02 0.00 0.00 0.02 0.02 - -Neonatal Tetanus 50,118 - - - 0.00 0.00 0.00 0.00 _Rubella 50,130 23.80 22.40 171.55 12.81 4.07 2.05 1.95 - -Mumps 50,131 41.20 39.30 117.00 37.80 8.10 6.50 6.30 - -Clinically Diagnosed AIDS 50,312 0.20 0.20 0.10 0.20 0.20 0.20 0.30 - -
Life ExpectancyAt Birth, In Years 60,101 71.60 71.80 72.20 72.50 71.00 71.70 72.60 73.1 -At Age 1, In Years 60.201 - -- - - .- - - -At Age S, In Years 60,202 _ _ _ _ _ _ _ _At Age 45, In Years 60,203 | _ _ _ _ _ _ _At Age 65, In years 60,204 _ _ _ _ _ _ _ _ProbabittyOf DgtBiefte sym MAN 0Populaton 60,401 i
Infant Mortality/1,000 Live Births 70,100 14.00 13.10 11.70 10.70 11.10 11.60 9.90 10.19Matemal DeatlhsI00,000 Live Births 80,100 - - 12.36 10.83 8.61 4.26 10.30 10.29
Standard Death Rates Per 100,000 Populaton tCirculatory, All Ages 90,102 - - - 571.84 551.91 518.34 463.57 - -Malignant Neoplasms, All Ages 100,102 226.60 210.10 221.70 228.08 219.52 213.17 206.65 - -All Causes, All Ages 990,102 - - - 1094.17 1144.96 1083.23 1084.52 - -Infectous/Parasitic, All Ages 993,002 - - - 10.75 9.31 9.49 8.43 - -Respiratory System; All Ages 993,202 - - - 29A8 39.36 47.07 51.29 - -MentbUNervous/Sensory, All Ages 993,702 - - - 8.16 7.14 5.54 4.39 - -
Crude Birth Rate (Per 1,000 Population) 998,004 12.6 1.0 188 11.62 10.8 9.2 9.7 117-Crude Death Rate (Per 1,000 Population) 998,005 11.36 11.26 11.25 10.73 11.45 10.82 10.20 10.36 -Total Fertility Rate 998,006 - - - 1.69 1.5 1.7 . _
TABLE 17A. CZECH REPUBLIC: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Ufestyles
Incidence Tuberculosist100,000 40,301 21.20 19.80 18.40 18.70 20.20 19.30 18.00 - -
Incidence HepatiUis/100,000 40,310 34.20 47.00 41.80 28.30 20.70 20.90 18.00 - -
Incidence Gonorrhea/100,000 40,322 57.00 61.70 58.60 61.10 69.10 70.80 44.40 - -
SDR Car Accidents/1 00,000 110,201 - - - - - 13.90 13.60 - -
Fatalities-Work Accidents/100,000 110,503 - - - - -- - - -
SDR Suicide+Self Injury/100,000 120,101 17.90 18.10 17.60 18.40 18.80 18.10 - -
Nutrition% Of Total Energy From Fat 160,306 - - 37.50% 37.50% - - - - -
% Of Total Energy From Protein 160,307 - -_ | 12.40% _ _ _% Of Total Energy From Alcohol 160,308 - - - - - - - -_
% Neonates Weighing More Than 2500g 160,401 94.59% 94.56% 94.82% 94.51% 94.13% 94.29% 94.38% _Annual Liters AlcohoVPerson 170,101 8.00 8.10 8.20 8.90 9.10 9.40 - _Annual Cigarette Consumption/Person 170,902 1832.00 1750.00 1776.00 2808.50 2025.00 2825.20 2824.60 _Nonsmokers In Population (%) 171,001 62.00% 63.00% 64.00% 61.00% 60.00% 59.00% - _
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 71.60% 72.10% 72.40% 72.60% 72.30% - _ _Urban 200,108 - - - - - _ _ _ _
Rural 200,109 - - - - - _ _ _ _
% Population With Water Supply In HomeTotal 992,001 80.90% 81.50% 82.40% 83.20% 84.00% _ _ _Urban 992,002 - - - - - _ _ _
Rural 992,003 _ _ _ _ _ _ _ _
TABLE 17B. CZECH REPUBLIC: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulatonDoctors 270,201 - - - 270.00 - - 320.00 290.00Qualified nurses 270,202 787.34 798.76 808.35 809.15 793.16 760.98 760.25 -Denfists 270,203 53.08 53.46 53.95 54.60 54.59 50.69 57.02 _Pharmaist 270.204 - - - 43.00 41.00 40.00 37.00--Midwives 270,209 - - - - - - - - -
% Doctors Working In Hospitals 270.321 28.78% 28.77% 29.00% 29.68% 31.48% 48.35% 41.09% -% Nurses.Working In Hospitals 270,322 40.39% 40.49% 40.63% 42.30% 46.11% 56.80% 67.74% - -
Graduatng Per 100,000 PopulaUonDoctors 360,301 1068.00 1101.00 1120.00 1049.00 1237.00 1255.00 1347.00 - -Nurses 360,302 3786.00 3476.00 4023.00 4039.00 4586.00 5394.00 5755.00 - -Dentists 360,303 143.00 93.00 122.00 119.00 88.00 85.00 136.00 - -Pharmacists 360,304 192.00 181.00 202.00 196.00 133.00 259.00 146.00 - -Midwives 360,305 - - - - - 266.00 267.00 - -
H"iath UnitsPrimary Care Until100,000 Population 270,206 - - - - - - -Hospitals/100,000 Population 270,210 1.50 1.50 1.50 1.60 1.60 1.70 1.80 - -Inpatient BedsW100,000 population 992,710 - - - 1090.00 - - 1220.00 980.00 -Psychiatric Beds/100,000 Population 992,711 147.83 147.43 146.88 140.00 132.78 126.68 120.78 120.08 -Nursing Home Beds1100,000 Population 992,712 - - - - - - - - -
Utilization Y% Children Immunized Against
Diptheria 280,101 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% _Tetanus 280,102 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% -_ Pertussis 280,103 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% _Measles 280,104 98.00% 97.00% 97.00% 97.00% 98.00% 97.00% - - -Polio 280,105 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% 99.00% - -Tuberculosis 280,106 98.00% 98.00% 98.00% 98.00% 98.00% 98.00% 98.00% - -
Abortionsl1,000 Live Births 280,500 952.00 963.00 987.00 965.00 918.00 891.00 694.00 - -Ambulatory Care Contacts/Person 992,801 15.05 15.05 14.86 13.90 13.70 13.21 13.40 14.76Inpient Admissions/100 Population 992,902 17.90 17.70 18.70 17.90 18.10 18.40 18.70 - -Average Length Of Stay (Days) 992,901 13.20 13.00 12.40 12.00 11.90 11.60 11.20 |
QualitySDR Appendicitis/100,000 Population 310,304 -_ -_ _ 0.40 - _SDR Drug Reactions/100,000 Popuation 310,306 _ - _ - _ 0.40 _ _Surgical Wound Infection Rate 310,701 - 5.80 5.90 6.60 1 -_
TABLE 17C. CZECH REPUBLIC: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFARefs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopultIonMeasles 50,111 0.00 0.10 0.00 2340 8.10 4.00 0.20 -
Malaria 50,112 _- - - - - - -
Diphtheria 50,113 - - - - 0.00 0.00 0.00 - -
Tetanus 50,114 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -
Acute Poliomyelitis 50,115 0.00 0.00 - - - 0.00 0.00 - -
Neonatal Tetanus 50,118 - - - - - 0.00 0.00 - -
Rubella 50,130 170.00 71.50 20.00 12.60 106.80 21.50 5.30 - -
Mumps 50,131 374.30 739.80 210.90 37.80 11.60 11.60 14.80 - -
Clinically Diagnosed AIDS 50,312 0.10 0.10 0.10 0.10 0.10 0.10 0.10 - -
Wfe ExpectancyAt Birth, In Years 60,101 71.46 71.70 71.80 71.70 72.00 72.30 72.90 - -
At Age 1, In Years 60,201 71.50 71.60 71.60 71.60 71.90 72.20 72.60 - -
AtAge 15, In Years 60,202 57.80 57.90 57.90 57.90 58.10 58.50 58.80 - -
At Age 45, In Years 60,203 29.30 29.40 29.30 29.40 29.70 29.50 30.30 - -
AtAge 65, In years 60,204 13.60 13.70 13.60 13.70 14.00 14.30 14.40 - -
Probability Of Dying Before 5 yrs /1,000 Population 60,401 - - - - - - - -
lnfant Mortalityl1,000 Live Births 70,100 12.00 11.00 10.00 10.80 10.40 9.90 8.50 - -
Matermal Deaths/100,000 Live Births 80,100 15.00 19.00 13.00 19.00 18.00 12.00 12.00 - -
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 656.50 634.20 645.50 647.00 615.50 591.50 576.40 - -
Malignant Neoplasms, All Ages 100,102 256.80 262.00 259.70 262.50 - 254.50 254.10 - -
All Causes, All Ages 990,102 - - - - - 1082.40 1052.60 - -
lnfectious/Parasilic, All Ages 993,002 - - - - - 3.40 2.90 - -
Respiratory System, All Ages 993,202 - - - - - 45.50 42.50 - -
Mental/Nervous/Sensory, All Ages 993,702 - - - - - 10.10 10.20 _
Crude Birth Rate (Per 1,000 Population) 998,004 12.70 12.90 12.40 12.70 12.60 11.80 11.80 _Crude Death Rate (Per 1,000 Population) 998,005 12.30 12.10 12.30 12.50 12.10 11.70 11.40 _Total Fertility Rate 998,006 1.90 1.90 1.90 1.90 1.80 1.90 1.70 _
TABLE 18A. FYR MACEDONIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs . 1987 1988 1989 1990 1991 1992 1993 1994 1995
tfestles
Incidence TuberculosisllOO,000 40,301 34.84 42.55 37.61 37.23 33.06 30.06 34.35 - -Inddence Hepatitfst100,000 40,310 137.04 228.60 166.70 132.35 81.41 88.81 149.73 2763.00Incidence Gonorrheatl00,000 40,322 7.72 5.63 4.81 7.15 5.89 3.99 1.40 35.00SDR:Car Acddents/100,000 110,201 11.08 11.01 0.10 10.75 7.36 6.61 5.79 -Fatalites-Work Accidents/100,000 110,503 - - - - - - - - -SDR Suicide.Self lnjury/1 00,000 120,101 6.47 6.98 7.43 6.85 7.16 7.00 7.24 - -NutriWion
% Of Total Energy From Fat 160,306 25.80% 27.70% 22.00% 23.70% 22.70% 24.70% 23.50% - -% Of Total Energy From Protein 160,307 11.90% 13.80%/ 14.90% 11.70% 12.30% 12.10% 10.70% - -% Of Total Energy From Alcohol 160,308 - - - - - - - - -
% Neonates Weighing More Than 2500g 160,401 - - - - - _ _Annual Liters Alcohot/Person 170,701 - - - - - - _Annual Cigarette Consumption/Person 170,902 - - - - - - _ _Nonsmokers In Population (%) 171,001 - - - - - - _ _
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - - - - 71.00°% _ _ l
Urban 200,108 - - - - _ _Rural 200,109 - - - - - _ _ | _
% Population With Water Supply In HomeTotal 992,001 - - - - 71.00% _ _ l
Urban 992,002 _- -_ _ _ _Rural 992,003 I -_ -_ - -
TABLE 18B. FYR MACEDONIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 195.19 203.29 213.97 216.77 220.06 221.98 218.43 -- -
Qualified nurses 270,202 263.96 273.89 283.30 275.79 273.27 274.56 271.97 - -
Dentsts 270,203 46.47 50.27 54.86 54.83 54.83 52.43 52.00 - -
Pharmacists 270,204 17.04 18.44 20.02 18.34 19.27 20.14 17.27 - -
Midwives 270,209 75.69 74.49 76.36 72.68 70.82 71.30 69.27 -
% Doctors Working In Hospitals 270,321 28.30% 28.80% 30.00% 29.30% 29.60% 30.20% 30.30% -% Nurses Working In Hospitals 270,322 - - - -- -- - - --
Graduating Per 100,000 PopulationDoctors 360,301 15.79 16.79 11.20 8.19 7.90 8.61 7.77 158.00Nurses 360,302 -- - - - - - -- -_
Dentists 360,303 5.41 6.08 3.96 4.44 3.63 3.02 3.47 42.00Pharmacists 360,304 2.01 3.29 2.48 1.63 2.01 2.09 2.99 42.00Midwives 360,305 -- - - - - -- -_
Health UnitsPrimary Care Units/100,000 Population 270,206 59.60 63.18 64.07 63.41 63.85 63.52 63.15Hospitals/100,000 Population 270,210 2.46 2.49 2.48 2.47 2.50 2.48 2.46Inpatient Beds/1 00,000 population 992,710 534.99 538.96 545.64 539.45 525.60 520.96 522.14 _Psychiatric Beds/1 00,000 Population 992,711 - - - 80.08 80.53 79.67 74.00 Nursing Home Beds/100,000 Population 992,712 - - -- -_
Utilization% Children Immunized Against:
Dipthera 280,101 97.40% 96.10% 95.20% 95.10% 95.70% 89.20% 89.70% 94.40%Tetanus 280,102 97.40% 96.10% 95.20% 95.10% 95.70% 89.20% 89.70% 94.40%Pertussis 280,103 97.40% 96.10% 95.20% 95.10% 95.70% 89.20% 89.70% 94.40%Measles 280,104 84.80% 86.50% 90.50% 88.20% 87.00% 66.90% 93.00% 96.80%Polio 280,105 95.40% 94.40% 93.50% 90.30% 94.60% 93.10% 96.00% 95.20%Tuberculosis 280,106 95.80% 96.70% 92.90% 93.10% 97.70% 87.20% -- -
Abortions/1,000 Live Births 280,500 16.20 13.50 15.09 10.80 11.36 9,66 9.05 _Ambulatory Care Contacts/Person 992,801 - - - - - - - _Inpatient Admissions/100 Population 992,902 _ _ _ _ _ _ _Average Length Of Stay (Days) 992,901 - -- -- - --
QualitySDR Appendicitis/100,000 Population 310,304 2.00 4.00 2.00 5.00 3.00 3.00 2.00SDR Drug Reactions/100,000 Population 310,306 - - -- --
Surgical Wound Infection Rate 310,701 I -1 -- I
TABLE 18C. FYR MACEDONIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulatonMeasles 50,111 103.71 80.82 28.49 64.25 8.88 8.75 120.36 229.00 -Maaria 50,112 0.00 0.10 0.00 0.00 0.05 0.00 0.05 1.00 -Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 -Tetanus 50,114 0.15 0.20 0.20 0.00 0.05 0.05 0.14 1.00 -Acute Poliomyeliffs 50,115 0.05 0.00 0.00 0.00 0.00 0.00 0.00 0.00 -Neonatal Tetanus 50,118 0.00 0.20 0.05 0.00 0.05 0.00 0.05 0.00 -Rubella 50,130 196.79 36.82 71.11 81.46 21.73 22.13 14.57 2020.00 -Mumps 50,131 177.99 50.62 88.75 69.48 90.78 106.08 113.31 1653.00 -Clinicalty Diagnosed AIDS 50,132 - - - 0.10 0.10 - - - -
Life ExpectancyAt Birth, In Years 60,101 - - - - 72.18 - - - -At Age 1, In Years 60,201 - - - - 73.37 - - - -AtAge 15, In Years 60,202 - - - - 59.85 - - - -AtAge45, InYears 60,203 - - - - 31.16 - - - -At Age 65, In years 60,204 - - - - 14.64 - - - -Probability Of Dying Before 5 yrs /1,000 Population 60,401 - - - - 0.03 - - - -
Infant Mortality/1,000 Uve Births - 41.92 39.81 36.71 31.64 28.25 30.63 27.33 - -Matemal Deatls/100,000 Live Births - 10.40 13.20 8.30 2.80 1.15 6.00 6.20 - -
Standard Death Rates Per 100,000 PopulaionCirculatory, All Ages 90,102 340.10 335.28 345.34 350.74 359.29 310.75 385.82 - -Malignant Neoplasms, All Ages 100,102 95.74 105.68 101.59 109.86 107.85 108.17 111.24 - -All Causes, All Ages _ _ _ _ _ _ _ _ _InfectiouslParasitic, All Ages 993,002 0.55 0.70 0.64 0.49 0.59 0.24 0.43 - -Respiratoty System, All Ages 993,202 54.19 48.68 49.65 45.81 43.06 43.39 34.54 - -MentalNervous/Sensory, All Ages 993,702 7.97 7.27 6.69 5.82 5.84 6.03 5.84 - -
Crude Birth Rate (Per 1,000 Population) 998,004 18.70 18.10 17.00 16.60 17.10 16.20 15.70 17.20 -Crude Death Rate (Per 1,000 Population) 998,005 7.10 7.00 6.90 6.90 7.30 7.80 7.45 8.10 -Total Fertility Rate 998,00e 2.27 2.22 2.09 #N/A 2.30 2.18 1 _
TABLE 19A. HUNGARY: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 38.90 37.90 35.60 34.60 35.40 38.40 -- -- --
Incidence Hepatitis/100,000 40,310 29.50 19.30 22.00 23.80 22.70 23.40Incidence Gonorrhea/i 00,000 40,322 55.80 - -- - - -
SDR CarAccidents/100,000 110,201 15.60 16.60 21.10 24.40 21.90 21.80Fatalites-Work Accidents/100,000 110,503 4.30 4.40 4.20 4.10 3.50 2.80SDR Suicide+Self Injury/100,000 120,101 43.80 39.90 40.00 38.20 36.90 37.00Nutrition
% Of Total Energy From Fat 160,306 37.50% 37.70% 37.40% 37.40% 38.80% 39.10%% Of Total Energy From Protein 160,307 11.10% 11.40% 11.10% 11.20% 10.70% 10.70%% Of Total Energy From Alcohol 160,308 6.70% 6.80% 6.80% 6.70% - --
% Neonates Weighing More Than 25009 160,401 -- -- - - -- 91.00%Annual Uters Alcohol/Person 170,101 10.70 10.40 10.90 10.80 10.50 10.50 - _Annual Cigarette Consumption/Person 170,902 2566.90 2512.90 2591.70 2748.60 2564.30 2647.30 2653.40Nonsmokers In Population (%) 171,001 -- -- -- -- -- 0.66 --
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - 93.50% --
Urban 200,108 E - 100.00% l o
Rural 200,109 85.00% - _% Population With Water Supply In Home
Total 992,001 _ _ - _ _ _Urban 992,002 -_ _ _ _Rural 992,0031 -_ _ _ _ _
TABLE 19B. HUNGARY: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropiate Care HFA Refts 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopultonDoctors 270,201 298.10 304.60 309.90 327.10 327.30 327.70 310.20 342.60Qualified nurses 270,202 291.30 293.70 305.90 - - - - -Dentsts 270,203 35.90 36.90 38.10 41.20 - - - -Phafmacists 270,204 43.10 42.50 42.00 43.50 - - - - _Midwives 270,209 25.50 24.70 25.10 26.00 - - - -
% Doctors Working In Hospitals 270,321 - - - - - - - -% Nurses Worldng In Hospitals 270,322 - - - - - - - -
Graduatng Per 100,000 PopulatonDoctors 360,301 9.20 9.10 8.70 - 940 - - - |Nurses 360,302 43.00 43.20 39.00 - 5.10 - - -Dentists 360,303 1.30 1.40 1.40 - 1.70 - - |Pharmacists 360,304 1.80 1.80 1.70 - 2.20 - - -Midwives 360,305 2.40 2.30 1.70 - - - - -
Health UnItsPrimary Care Units/I100,000 Population 270,206 - - - - -_ _ Hospitalsl100,000 Population 270,210 - - - - - - -_ 1.70Inpatient Beds/1i00,000 populabtion 992,710 - - - 980.00 1000.00 980.00 980.00 990.00Psychiatric Beds/100,000 Population 992,711 - - - - - - -_ Nursing Homve eWI00,000 Population 992,712 _ _ _ _ _ _ _ _ _
Utilization% Children Immunized Against:
Diptheria 280,101 100.00% 99.00%h 99.00% 99.00%o 99.90%h 99.90% - -Tetanus 280,102 100.00% 99.00% 99.00% 99.00% 99.90% 99.90% - - -Pertussis 280,103 100.00% 99.00% 99.00°h 99.00% 99.90% 99.90% - - -Measles 280,104 100.00% 99.00% 99.00% 99.00% 99.80% 99.80% - - -Polio 280,105 99.00% 99.00% 99.00% 99.00% 98.40% 99.90% - - -Tuberculosis 280,106 100.00%h 99.00% 99.80% 99.00% - - - - -
Abortions/l,000 Live Births 280,500 - - 734.00 0 _ 715.30 - - -Ambulatory Care Contacts/Person 992,801 _- - - - - - -Inpabent Admissions/1 00 Population 992,902 _- - - - - -Average Length Of Stay (Days) 992,901 - - - 12.60 12.40 12.00 11.80 11.30 -
QualitySDR Appendicitis/i 00,000 Population 310,304 0.70 0.60 0.60 0.60 0.50 0.60 _ _SDR Drug Reactions/ll0OoO Population 310,306 0.20 0.00 0.10 0.10 0.10 0.00 _ _Surgical Wound Infecbon Rate 310,701 _ _ _ - _ _
TABLE 19C. HUNGARY: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 0.20 10.40 160.00 0.30 0.50 0.40 0.40 -
Malaria 50,112 0.20 0.10 0.10 - - -- -
Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00Tetanus 50,114 0.30 0.20 0.20 0.20 0.10 0.10 -
Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 0.00 0.00 0.00 _Neonatal Tetanus 50,118 0.00 0.00 0.00 0.00 0.00 0.00 - _Rubella 50,130 195.30 256.40 188.20 47.90 12.20 11.40 _ _Mumps 50,131 413.40 471.30 214.50 205.80 210.60 287.10 - _Clinically Diagnosed AIDS 50,312 0.10 0.10 0.10 0.20 0.30 0.30 0.30 --
Life ExpectancyAt Birth, In Years 60,101 69.70 70.10 69.60 69.40 69.40 69.00 69.00 69.40At Age 1, In Years 60,201 69.90 70.20 69.70 69.40 69.50 69.00 - -
At Age 15, In Years 60,202 56.30 56.50 56.00 55.70 55.80 55.30 -
At Age 45, In Years 60,203 28.60 28.80 28.50 28.30 28.30 28.00 - _AtAge 65, In years 60,204 13.90 14.10 14.10 13.90 14.10 13.90 -
Probability Of Dying Before 5 yrs /1,000 Population 60,401 19.60 17.80 17.90 16.80 17.60 15.90 - -
Infant Mortality/1,000 Live Births 70,100 17.30 15.80 15.70 14.80 15.60 14.10 12.46 11.95Matemal Deaths/100,000 Live Births 80,100 13.50 16.90 15.40 20.70 12.60 9.90 18.80 10.38 -
40
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 636.60 620.60 624.50 644.70 638.20 639.80 _ _Malignant Neoplasms, All Ages 100,102 256.10 255.10 259.60 267.00 271.30 278.90 _ _All Causes, All Ages 990,102 1229.60 1197.30 1229.80 1261.60 1252.40 1284.20 _Infectious/Parasitic, All Ages 993,002 9.80 9.20 10.00 8.50 8.30 8.30 _Respiratory System, All Ages 993,202 54.10 50.90 58.20 57.20 53.80 59.30 _ _MentaVNervous/Sensory, All Ages 993,702 16.90 17.40 19.40 19.50 20.10 22.60 _ _
Crude Birth Rate (Per 1,000 Population) 998,004 11.90 11.70 11.70 12.10 12.30 11.80 11.37 11.27Crude Death Rate (Per 1,000 Population) 998,005 13.40 13.20 13.70 14.10 14.00 14.40 14.60 14.31Total Fertility Rate 998,006 -- - 1.80 1.80 1.80 1.80 1.70 -.
TABLE 20A. LITHUANIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 37.90 36.60 37.40 39.60 41.60 42.70 43.60 54.30 -Incidence Hepatitis/100,000 40,310 - - 206.60 128.00 74.20 86.40 111.00 153.40 -Incidence Gonorrhea/100,000 40,322 - - 93.70 79.50 82.10 107.80 150.00 147.80 -SDR Car Accidents/100,000 110,201 19.00 26.10 31.40 30.80 37.30 24.80 27.30 29.40 -Fatalities-Work Accidents/i 00,000 110,503 - - - - - - - - -SDR Suicide+Self Injury/100,000 120,101 30.30 27.50 28.10 27.00 31.70 36.00 43.50 48.30 -Nutribon
% Of Total Energy From Fat 160,306 -- - - - - -- - -% Of Total Energy From Protein 160,307 _ _ _ _% Of Total Energy From Alcohol 160,308 _ _ _
% Neonates Weighing More Than 25009 160,401 - - - -- - - -_Annual Liters Alcohol/Person 170,101 4.80 5.50 6.30 5.00 4.80 4.30 4.40 4.60Annual Cigarette Consumption/Person 170,902 - 1243.60 1213.50 1195.20 1304.80 1304.50 1308.50 1312.30Nonsmokers In Population (%) 171,001 - - -- - -- - -- --
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - - _ _ - _Urban 200,108 - - _ _ _ _ _Rural 200,109 - - _ _ | _ _ _
% Population With Water Supply In HomeTotal 992,001 - _ _ - _Urban 992,002 _ _ _ _ _ l _Rural 992,0031 _ _ _ _ .
TABLE 20B. LITHUANIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Ledlcal Personnel Per 100,000 Popula'onDoctors 270,201 - - 397.70 401.30 386.60 388.40 393.30 400.30 -
Qualified nurses 270,202 - - 820.00 805.00 779.00 783.00 781.00 794.00Dentsts 270,203 - - 61.20 60.30 56.70 55.80 52.30 50.20Pharmacists 270,204 - - - 53.10 - - -Midwives 270,209 - - 112.00 106.00 53.00 49.00 49.00 47.00
% Doctors Working In Hospitals 270,321 - - - - - - - -
% Nurses Working In Hospitals 270,322 - - - - - - - -
Graduating Per 100,000 PopulaionDoctors 360,301 - - 10.10 10.00 10.30 12.60 12.60 12.20 -
Nurses 360,302 - - 43.20 42.10 41.30 13.00 33.80 #N/A -
Dentists 360,303 - - 1.30 1.40 1.90 2.10 2.80 3.20 -
Pharmacists 360,304 - - 1.40 3.00 3.40 2.50 3.20 3.40 -
Midwives 360,305 - - 1.40 3.00 3.40 2.50 3.20 - -
Health UntsPrimary Care Units/100,000 Populabon 270,206 - - - - - - - - -
Hospitals/100,000 Population 270,210 - - 5.20 5.29 5.30 5.32 5.32 5.32 -Inpatient Beds/100,00 populabon 992,710 - - - 1240.00 1270.00 1190.00 1180.00 1110.00 -
Psychiatric Beds/100,000 Population 992,711 - - - - - - - - -
Nursing Home Beds/100,000 Populabon 992,712 - - - 214.46 190.37 194.21 204.60 215.31 -
Utilization% Children Immunized Against
Diptheria 280,101 - - 81.90% 78.40% 74.90% 87.20% 86.80% 87.20% -
Tetanus 280,102 - - 81.90% 78.40% 74.90% 87.20% 86.80% 87.20% -
Pertussis 280,103 - - 79.80% 76.20%/a 73.20% 77.60% 79.30% 82.20% -
Measles 280,104 - - 92.40% 89.00% 85.70% 89.00% 91.80% 92.70% -
Polio 280,105 - - 86.60% 77.10% 79.00% 88.20% 86.30% 87.70% -
Tuberculosis 280,106 - - 91.80% 93.90% 87.40% 93.90% 97.60% 95.90% -
Abortions/1,000 Live Births 280,500 - - 756.10 742.10 733.70 757.70 743.30 - -
Ambulatory Care Contacts/Person - - - - - - - - - -
lnpatent Admissions/1 00 Populaton -- -_ 19.23 18.56 18.83 18.88 19.73 20.13 -
Average Length Of Stay (Days) - - - 18.20 17.90 17.60 17.10 16.70 16.00 -
QualityISDRAppendicitis1100,000 Population 310,301 0.30 0.30i 0.50 0.20 0.30 0.30 0.10 0.10-SDR Drug Reactions/i00,000 Populabon 310,306 _ - _ _Surgical Wound Infection Rate 310,701 _ _ _ _ _ _ _ _
TABLE 20C. LITHUANIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 - -- 7.50 1.30 3.80 5.30 6.70 7.70 --Malaria 50,112 0.30 0.10 - 0.10 0.20 0.10Diphtheria 50,113 -- 0.00 0.00 0.20 0.20 1.00 -Tetanus 50,114 0.00 0.20 0.00 0.10 0.10 0.10 -Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 0.00 0.00 -Neonatal Tetanus 50,118 _- -- 0.00 0.00 0.00 0.00 -Rubella 50,130 80.90 24.10 31.80 22.20 30.20 28.60 -Mumps 50,131 _ 17.60 12.50 11.20 17.20 15.30 14.80 -Clinically Diagnosed AIDS 50,312 0.00 0.00 0.00 0.00 0.00 0.00 0.10 0.10 -
Life ExpectancyAt Birth, In Years 60,101 72.20 72.00 71.80 71.50 70.70 70.50 69.00 68.7AtAge 1, In Years 60,201 72.10 71.80 71.50 71.30 70.70 70.70 69.10 --At Age 15, In Years 60,202 58.50 58.40 58.00 57.70 57.20 57.20 55.60 _At Age 45, In Years 60,203 31.00 31.00 30.90 30.50 30.40 30.30 29.00At Age 65, In years 60,204 15.60 15.70 25.80 15.60 15.80 15.60 15.00 _Probability Of Dying Before 5 yrs /1,000 Population 60,401 15.50 15.20 14.00 13.30 17.20 19.70 18.70 --
Infant Mortalityl1,000 Live Births 70,100 12.30 11.60 10.70 10.20 14.30 16.50 16.00 16.50Matemal Deaths/100,000 Live Births 80,100 21.90 19.40 28.70 22.90 19.60 20.50 12.80 16.34
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 590.20 580.00 571.00 587.20 573.20 563.00 626.80 -- YlMalignant Neoplasms, All Ages 100,102 181.20 185.10 186.50 192.50 193.80 199.90 204.20All Causes, All Ages 990,102 1014.00 1016.20 1018.40 1046.40 1070.40 1082.30 1196.40Infectious/Parasitic, All Ages 993,002 9.20 9.80 9.30 9.60 10.60 10.90 13.90Respiratory System, All Ages 993,202 52.40 53.30 46.60 47.50 44.30 40.30 46.80MentaUNervous/Sensory, All Ages 993,702 13.90 14.20 16.10 16.30 20.20 21.00 28.90 -
Crude Birth Rate (Per 1,000 Population) 998,004 16.40 15.50 15.10 15.30 15.00 14.30 12.50 11.51Crude Death Rate (Per 1,000 Population) 998,005 10.20 10.30 10.30 10.70 11.00 11.10 12.40 12.44Total Fertility Rate 998,006 - _ 2.00 _ 2.00 1.90 1.80 _
TABLE 21A. POLAND: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 52.50 49.00 42.60 42.30 43.10 43.10 43.80 -- --Incidence Hepatitis/100,000 40,310 64.40 57.60 66.10 78.50 96.00 129.10 108.60Incidence Gonorrhea/100,000 40,322 20.40 20.30 22.20 21.60 14.10 9.70 7.80SDR Car Accidents/1 00,000 110,201 14.20 14.90 20.40 22.40 23.20 19.70 18.00Fatalities-Work Accidents/100,000 110,503 2.70 2.60 2.40 2.10 2.10 1.70 1.70 _SDR Suicide+Self Injury/100,000 120,101 14.10 13.00 12.00 13.80 14.70 15.60 14.60Nutrition
% Of Total Energy From Fat 160,306 32.40% 32.60% 32.60% 31.70% 32.00% 32.10%% Of Total Energy From Protein 160,307 11.80% 11.80% 11.80% 11.90% 12.20% 12.00%% Of Total Energy From Alcohol 160,308 3.50% 3.50% 3.40% 3.30%
% Neonates Weighing More Than 25009 160,401 92.10% 92.40% 92.40% 91.10% 92.00% 92.10% 92.10%Annual Liters AlcoholPerson 170,101 7.20 7.10 7.00 6.20 7.10Annual Cigarette Consumption/Person 170,902 2741.80 2511.00 2530.70 2700.60 2946.00 2424.10 2421.90 _Nonsmokers In Population (%) 171,001 54.50 59.00 _
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - - 100.00% --
Urban 200,108 - - 100.00% _ _Rural 200,109 - - 100.00% _ _ _ --
% Population With Water Supply In HomeTotal 992,001 - - _Urban 992,002 _Rural 992,003 _ _
TABLE 21 B. POLAND: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 205.80 207.80 208.70 214.30 216.80 218.20 222.00 - -Qualified nurses 270,202 488.30 491.70 501.40 527.10 519.00 517.60 518.20 - -Oentists 270,203 46.90 47.50 47.00 47.80 45.90 43.30 44.10 - -Pharmacists 270,204 42.50 42.80 42.00 39.60 42.10 42.60 45.70 - -Midwives 270,209 57.40 58.10 59.20 62.60 62.10 61.60 61.80 - -
% Doctors Working In Hospitals 270,321 - - - - - - - - -% Nurses Working In Hospitals 270,322 - -- -- - - - -- - -
Graduafing Per 100,000 PopulationDoctors 360,301 8.60 8.30 8.00 8.50 9.00 9.70 10.50 -Nurses 360,302 0.80 0.60 0.60 0.60 0.70 0.80 0.90 -Dentists 360,303 2.30 2.40 2.40 2.30 2.50 2.80 2.90Pharmacists 360,304 1.40 1.50 1.70 1.80 1.70 1.70 1.80Midwives 360,305
Heakth UnitsPrimary Care Units/100,000 Population 270,206 17.40 17.60 17.60 17.30 16.50 15.70 15.60 -Hospitals/100,000 Population 270,210 1.90 1.90 1.90 1.90 1.90 1.90 1.90 -Inpatient Beds/100,000 population 992,710 5.70 5.70 5.70 5.70 5.70 5.60 5.60 -Psychiatric Beds/100,000 Population 992,711 90.90 88.80 88.10 87.00 84.50 81.40 80.20 -Nursing Home Beds/100,000 Populabon 992,712 1.74 1.76 1.77 1.78 1.82 1.87 1.96 -
Utilization% Children Immunized Against:
Diptheria 280,101 99.30% 99.30% 99.30% 99.30% 99.10% 99.10% 99.20% _Tetanus 280,102 99.20% 99.30% 99.10% 99.30% 99.20% 99.10% 99.20%/-Pertussis 280,103 97.50% 97.60% 97.40% 97.20% 96.80% 96.70% 96.70%Measles 280,104 95.20% 96.40% 96.70% 96.80% 96.10% 96.00% 96.50% _Polio 280,105 98.70% 98.80% 98.40% 98.40% 98.50% 98.30% 98.50% _Tuberculosis 280,106 94.80% 95.00% 95.00% 96.90% 94.00% 94.30% 95.20% -
Abortions1,000 Live Births 280,500 204.00 179.20 146.00 108.90 56.40 22.70 22.50 -Ambulatory Care Contacts/Person 992,801 7.80 7.60 7.40 7.10 7.00 6.50 6.40 -lnpatient Admissions/100 Population 992,902 12.20 12.20 11.90 12.10 12.20 12.40 12.80 -Average Length Of Stay (Days) 992,901 12.30 12.60 12.50 12.50 12.30 11.80 11.40 -
QualitySDR Appendicitis/i 00,000 Population 310,304 0.60 0.50 0.60 0.40 0.40 0.40 i _SDR Drug Reactions/100,000 Population 310,306 0.2 0.20 0.20 0.20 0.20 0.20 - -Surgical Wound Infection Rate 310,70 _ _ _
TABLE 21C. POLAND: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 3.40 2.70 19.00 148.10 6.30 9.60 3.80 - --
Malaria 50,112 -- 0.00 0.00 -- -- - --
Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00Tetanus 50,114 0.20 0.20 0.20 0.20 0.20 0.10 0.10Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 0.00 0.00 0.00Neonatal Tetanus 50,118 0.00 0.00 0.00 0.00 0.00 0.00 0.00 _Rubella 50,130 50.80 178.10 54.40 45.60 155.40 1039.20 166.50Mumps 50,131 302.00 178.10 213.90 142.60 142.20 110.00 299.80Clinically Diagnosed AIDS 50,312 0.00 0.00 0.10 0.10 0.10 0.10 0.10
Life ExpectancyAt Birth, In Years 60,101 70.90 71.30 71.10 71.00 70.60 71.10 71.70At Age 1, In Years 60,201 71.20 71.50 71.20 71.10 70.70 71.20 71.70At Age 15, In Years 60,202 57.50 57.80 57.60 57.40 57.00 57.50 57.90 _At Age 45, In Years 60,203 29.50 29.80 29.70 29.60 29.30 29.70 29.80At Age 65, In years 60,204 14.30 14.60 14.60 14.60 14.40 14.70 14.30Probability Of Dying Before 5 yrs /1,000 Population 60,401 19.80 18.40 18.30 18.30 17.10 16.50 --
Infant Mortality/1,000 Live Births 70,100 17.50 16.20 16.00 16.00 15.00 14.50 13.30Matemal Deaths/100,000 Live Births 80,100 15.50 11.60 10.70 12.80 12.80 9.90 11.70
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 605.20 580.40 587.50 589.20 609.30 584.60 529.80 _Malignant Neoplasms, All Ages 100,102 209.50 212.10 211.00 212.80 213.80 211.10 199.40All Causes, All Ages 990,102 1145.30 1105.10 1118.20 1123.40 1157.30 1116.30 1016.30Infectious/Parasitic, All Ages 993,002 9.80 9.40 9.10 8.90 8.50 8.30 7.20Respiratory System, All Ages 993,202 53.50 47.10 48.50 44.90 42.90 37.40 35.80 _MentallNervous/Sensory, All Ages 993,702 13.90 13.60 13.40 14.00 15.50 15.00 12.40
Crude Birth Rate (Per 1,000 Population) 998,004 16.10 15.50 14.80 14.30 14.30 13.40 12.80 _Crude Death Rate (Per 1,000 Population) 998,005 10.00 9.80 10.00 10.20 10.60 10.20 10.20Total Fertility Rate 998,006 _ _ 2.10 2.10 2.10 1.90 1.80 _
TABLE 22A. ROMANIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Rofs 1987 1988 1989 199i 1991 1992 1993 1994 1995
Incdence TuberculosWi100,000 40,301 58.20 61.40 63.40 70.10 66.80 79.40 82.50 87.30 _Incdence Hepatitiso100,000 40,310 242.90 306.90 351.50 322.10 218.60 117.70 89.50 118.70 _Inidence Gonorrheall 00,000 40,322 46.20 41.50 35.70 33.50 28.10 28.30 26.40 25.80 _SDR Car AccdentsVl00,000 110,201 - - 9.80 19.50 16.80 15.40 14.20 20.50 _Fatalities-Work ACcikents/10.000 110,503 3.90 3.50 3.50 - 3.00 2.90 2.20 - - _SOR Suicide.Self Injury100,000 120,101 - - 11.50 9.40 9.80 12.00 12.70 12.90Nutriton
% Of Total Energy From Fat 160,306 26.90% 26.70% 24.90% 27.20% 27.60% 27.20%h 34.20% - _% OfTotal Energy From Protein 160,307 12.10% 12.30% 12.10% 12.20% 12.20% 11.70°h 14.40% _ _% Of Total Energy From Alcoho 160,308 47.00% 0.50% 4.80% 4.80% - - - - _
% Neonates Weighing Moxe Than 2500g 160,401 92.50% 92.50% -92.70% 92.90% 92.10%h 91.80% 89.10% 91.40% _Annual Liters AlohotUPerson 170,101 7.80 7.90 6.60 7.30 6.40 - - - _Annual Cigarette ConsumptionrPerson 170,902 1281.60 1367.50 1386.50 1383.20 1078.30 1206.70 1118.90Nonsmokers In Popuaton (%) 171,001 - - - 71.60% 72.00% - - 72.00% _
Healty Environment
% Population Wlth Access To Hyglenic Sewage DisposalTotal 200,107 _- - 49.00% _ _Urban 200,108 _- - 85.00% _ _ _Rural 200,109 _- -| _ _
% Populaton With Water Supply In HomeTotal 992,001 - _ _ _ _ 51.00% _ _ _Urban 992,002 1 _ _ _ - 72.00% 0 _ _Rura 992,003 _ _ _ _ . _ _ _ _
TABLE 22B. ROMANIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 178.90 180.50 181.20 180.20 181.60 186.60 177-00 176.50 --Qualified nurses 270,202 373.90 370.80 367.50 354.80 337.50 346.50 346.90 386.90Dentists 270,203 31.40 31.30 30.70 28.90 27.90 28.50 27.80 26.00Pharmacists 270,204 28.40 28.10 27.80 27.10 21.90 16.80 12.30 12.40Midwives 270,209 52.70 53.40 53.90 50.50 47.80 47.40 46.60 46.90
% Doctors Working In Hospitals 270,321 38.20% 38.40% 37.10% 40.70% 39.40% 39.20% 37.80% 40.80%% Nurses Working In Hospitals 270,322 41.90% 42.20% 42.60% 44.10% 45.00% 45.70% 47.20% 48.60%
Graduating Per 100,000 PopulationDoctors 360,301 - -- -- 2.65 2.45 2.74 2.73 --Nurses 360,302 _ 3.29 3.30 3.57 4.56Denbsts - - - - -- _ Pharmacists 360,304 _ _ 0.13 0.13 0.12 0.13Midwives -- -- -- -- -- -- -- -- --
Health UnitsPrimary Care Units/100,000 Population 270,206 23.92 23.86 22.66 25.35 25.65 25.59 26.17 26.43Hospitals/100,000 Population 270,210 1.84 1.84 1.84 1.82 1.84 1.89 1.90 1.82Inpatient Bedsl100,000 population 992,710 900.00 890.00 890.00 890.00 890.00 790.00 790.00 770.00Psychiatric Beds/100,000 Population 992,711 80.00 79.00 79.00 78.00 79.00 77.00 77.00 76.06Nursing Home Beds/100,000 Population 992,712 -- -- - -- -- - -- --
Utilization% Children Immunized Against:
Diptheria 280,101 92.00% 96.00% 96.00% 96.00% 97.50% 97.50% 97.60%Tetanus 280,102 92.00% 96.00% 96.00% 96.00% 97.50% 97.50% 97.60%Pertussis 280,103 92.00% 96.00% 96.00% 96.00% 97.50% 97.50% 97.60%Measles 280,104 90.00% 78.00% 90.00% 92.00% 92.30% 90.60% 90.20%Polio 280,105 90.00% 92.00% 95.00% 92.00% 90.30% 91.70% 97.60%Tuberculosis 280,106 95.00% -- 90.00% 91.00% 99.10% 99.10% 99.10% --
Abortions/1,000 Live Births 280,500 476.10 487.90 522.30 3152.60 3149.30 2657.00 2343.10 2148.80Ambulatory Care Contacts/Person 992,801 9.90 10.00 9.60 8.30 7.60 7.90 8.10 8.10Inpatient Admissions/100 Population 992,902 22.60 23.00 22.60 20.10 19.00 20.20 20.40 21.10Average Length Of Stay (Days) 992,901 11.10 11.00 11.10 11.40 11.70 11.70 11.60 11.10
QualitySDR Appendicitisl100,000 Population 310,304 0.66 0.60 0.43 0.44 0.37 0.42 0.31 --SDR Drug Reactions/100,000 Population 310,306 -- -- -- -- -- --
Surgical Wound Infection Rate 310,701 1 _
TABLE 22C. ROMANIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 51.60 7.90 16.70 20.20 7.70 26.60 124.50 27.40 --
Malaria 50,112 0.07 0.03 0.02 0.05 0.05 0.08 0.09 0.09Diphtheria 50,113 0.01 0.01 0.02 0.00 0.00 0.00 0.00 0.00Tetanus 50,114 0.16 0.13 0.09 0.15 0.10 0.16 0.13 0.11Acute Poliomyelitis 50,115 0.05 0.07 0.05 0.03 0.13 0.08 0.04 --
Neonatal Tetanus 50,118 0.00 0.00 0.00 0.00 0.00 0.01 0.00 0.00Rubella 50,130 285.10 82.50 104.80 47.20 37.00 26.40 41.70 206.80Mumps 50,131 297.80 289.80 182.50 131.50 150.80 134.30 156.00 281.30Clinically Diagnosed AIDS 50,312 0.02 0.06 1.20 4.50 2.31 2.33 1.76 -
Life ExpectancyAt Birth, In Years 60,101 69.00 69.30 69.60 69.70 70.10 69.50 68.50At Age 1, In Years 60,201 70.10 70.20 70.50 70.60 70.70 70.20 --.
At Age 15, In Years 60,202 57.00 57.10 57.40 57.50 57.40 56.90At Age 45, In Years 60,203 29.20 29.30 29.70 29.70 29.60 29.10AtAge 65, In years 60,204 13.80 13.80 14.20 14.40 14.20 14.00 _Probability Of Dying Before 5 yrs /1,000 Population 60,401 36.90 33.90 34.90 34.30 28.70 28.90 -- -
Infant Mortality/1,000 Live Births 70,100 28.90 25.40 26.90 26.90 22.70 23.40 23.30 23.90Matemal Deaths/100,000 Live Births 80,100 150.10 155.50 169.40 83.60 66.50 60.30 53.20 60.40
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 765.10 751.70 712.30 705.70 729.50 751.10 712.40 709.90Malignant Neoplasms, All Ages 100,102 146.40 150.00 148.50 147.90 149.30 154.30 158.90 162.20All Causes, All Ages 990,102 1262.20 1241.10 1192.50 1168.60 1187.90 1223.70 -- -
Infectious/Parasitic, All Ages 993,002 12.30 11.40 12.10 12.50 12.10 13.50 - -
Respiratory System, All Ages 993,202 132.90 124.80 116.80 105.90 102.70 101.70 79.70 80.60 .Mental/Nervous/Sensory, All Ages 993,702 17.30 18.20 17.10 15.80 14.40 16.30 - --
Crude Birth Rate (Per 1,000 Population) 998,004 16.70 16.50 16.00 13.60 11.90 11.40 11.00 10.90Crude Death Rate (Per 1,000 Population) 998,005 11.10 10.90 10.70 10.70 10.90 11.60 11.60 11.70Total Fertility Rate 998,006 -. -- 2.10 2.20 1.90 1.50 1.40 1.40
TABLE 23A. SLOVAKIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Incidence Tuberculosist100,000 40,301 33.50 30.20 27.30 26.20 29.90 31.50 33.80 - -Incidence Hepatitis/100,000 40,310 51.30 69.40 48.10 37.60 44.30 51.90 51.90 33.90Incidence Gonorrhea/100,000 40,322 41.10 35.30 30.40 37.50 37.60 34.80 25.40 13.00SDR Car Accidentsl100,000 110,201 - - - - - - - -Fatalities-Work Accidentsl100,000 110,503 - - - - - - - _SDR Suicide+Sef Injury/100,000 120,101 13.00 12.60 11.30 13.70 11.00 10.40 6.70 _Nutrition
% Of Total Energy From Fat 160,306 - - - - - - -% Of Total Energy From Protein 160,307 _ | _ _ _ _ _ _% Total Energy From Alcohol 160,308 - - - - _ _ _ _
%-Neonates Weighing More Than 2500g 160,401 94.30% 94.10% 94.20% 94.00% 93.60% - _ _Annual Liters AlcohoUPerson 170,101 9.80 9.50 9.60 10.40 10.30 9.70 _ _ _Annual Cigarette Consumption/Person 170,902 1636.00 1567.00 1535.00 5518.80 5056.00 5485.50 _ _Nonsmokers In Populabon (%) 171,001 - - - - 76.00% - _ _ .
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 48.00% 49.00% 49.90% 50.70% 51.20% 50.90% _ | _Urban 200,108 - - - - - - _Rural 200,109 - - - - - - _ _ _
% Population With Water Supply In HomeTotal 992,001 - - - - - - _ |Urban 992,002 - - - - - - _ |Rural 992,003 - _ . _ _
TABLE 23B. SLOVAKIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989| 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 302.27 304.73 303.51 309.51 323.14 382.03 314.70 300.66 -
Qualified nurses 270,202 676.32 686.16 693.50 700.84 708.12 723.72 709.85 701.24Dentists 270,203 0.45 0.39 0.32 0.24 0.49 0.66 0.13 0.41Pharmacists 270,204 36.33 37.34 37.82 37.64 39.11 37.85 30.72 19.45Midwives 270,209 - - - 48.70 48.90 50.50 - -
% Doctors Working In Hospitals 270,321 13.00% 12.00% 13.00% 12.00% 14.00% 14.00% 13.00% 13.00%% Nurses Working In Hospitals 270,322 48.00% 48.00% 48.00% 47.00% 51.00% 53.00% 51.00% 53.00%
Graduating Per 100,000 PopulationDoctors 360,301 - - - 7.70 8.40 - -
Nurses 360,302 51.30 48.80 46.60 45.30 45.20 55.60 72.70 _Dentists 360,303 - - - 0.70 0.80 - - _Pharmacists 360,304 _ _ _ 2.40 3.00 - _ _Midwives 360,305 - - - 2.20 3.50 4.30 - - -
Health UnitsPnrmary Care Units/100,000 Population 270,206 43.30 43.30 42.50 41.70 37.90 36.20 33.80 31.20 -
Hospitals/100,000 Population 270,210 1.50 1.50 1.50 1.50 1.60 1.65 1.60 1.60Inpatient Beds/100,000 population 992,710 740.00 740.00 750.00 740.00 760.00 760.00 780.00 710.00 -
Psychiatric Bedsf100,000 Population 992,711 26.90 26.80 27.40 29.80 33.50 32.80 33.20 32.00 -
Nursing Home Bedst100,000 Population 992,712
Utilization% Children Immunized Against:
Dipthera 280,101 98.00% 99.00% 99.10% 99.40% 99.70% 99.30% - 99.00% Tetanus 280,102 98.00% 99.00% 99.10% 99.40% 99.70% 99.30% 99.00% _Pertussis 280,103 98.00% 99.00% 99.10% 99.40% 99.70% 99.30% 99.00%Measles 280,104 97.70% 99.20% 98.90% 98.50%A 98.00% 96.20% -
Polio 280,105 98.70% 98.90% 98.80% 99.00% 99.20% 98.60% 99.00% 0oTuberculosis 280,106 99.20% 98.70% 98.70% 98.20%Ao 92.50% 98.60% -- -
Abortions/1,000 Live Births 280,500 681.10 705.10 702.00 702.60 671.40 660.00 621.80 622.20Ambulatory Care ContactslPerson 992,801 - -- - - - - -- --Inpatient Admissions/i00 Population 992,902 -- - - - - - - --Average Length Of Stay (Days) 992,901 13.30 15.00 14.20 13.70 12.90 13.40 12.70 11.40
QualitySDR Appendicitis/i 00,000 Population 310,304 . . -. - - -. -SDR Drug Reactions/1 00,000 Population 310,306 . _ _ . _ _ _ _ _Surgical Wound Infection Rate 310,701 _ _ _ _ .
TABLE 23C. SLOVAKIA: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Health Status HFA Refs 1987 1989 1989 1990 1991 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 -- - -- 0.90 4.00 7.80 - - --Malaria 50,112 - 0.00 0.00 0.00 - _Diphtheria 50,113 _ _ _ - 0.00 0.00 -Tetanus 50,114 _ | 0.00 0.00 0.00 - _Acute Poliomyelitis 50,115 | _ 0.00 0.00 0.00 _Neonatal Tetanus 50,118 | 0.00 0.00 0.00 _ _Rubella 50,130 | _ 3.20 42.80 1.40 _Mumps 50,131 _ | _ 39.60 21.50 9.80Clinically Diagnosed AIDS 50,312 _ - _ 0.00 0.00 0.00 --
Life ExpectancyAt Birth, In Years 60,101 71.19 71.31 71.13 71.04 70.96 71.89 72.50At Age 1, In Years 60,201 71.38 71.41 71.26 71.12 71.13 #NMA 72.39At Age 15, In Years 60,202 57.71 57.72 57.57 57.42 57.45 #NMA 58.67At Age 45, In Years 60,203 29.40 29.40 29.30 29.30 29.30 #N/A 30.40 |At Age 65, In years 60,204 14.29 14.27 14.26 14.30 14.20 #NIA 15.00 --Probability Of Dying Before 5 yrs /1,000 Population 60,401 0.15 0.25 0.24 0.21 0.23 0.21 0.17 0.16
Infant Mortality/1,000 Live Births 70,100 14.60 13.30 13.50 12.00 13.20 12.60 10.60 11.20Maternal Deaths/100,000 Live Births 80,100 3.60 16.80 15.00 6.30 14.00 1.30 12.30 6.00
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 500.40 507.50 522.80 549.80 546.40 520.60 517.90 525.30Malignant Neoplasms, All Ages 100,102 188.90 195.90 195.90 195.40 198.60 200.50 201.50 201.10All Causes, All Ages 990,102 995.10 999.30 1021.60 1031.00 1033.80 1008.00 991.10 961.10 -Infectious/Parasitic, All Ages 993,002 3.10 2.80 2.90 2.50 3.70 3.90 3.70 4.10 -Respiratory System, All Ages 993,202 97.20 86.70 90.60 75.10 77.10 77.40 78.70 65.20 -Mental/Nervous/Sensory, All Ages 993,702 9.10 8.90 8.40 7.30 5.80 4.30 6.10 5.97 -
Crude Birth Rate (Per 1,000 Population) 998,004 16.16 15.93 15.25 15.17 14.90 14.13 13.82 12.50iCrude Death Rate (Per 1,000 Population) 998,005 9.95 9.99 10.22 10.31 10.34 10.08 9.91 9.61Total Fertility Rate 998,006 2.15 2.15 2.08 2.09 - -- -- -_
TABLE 24A. SLOVENIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 32.10 31.30 39.40 37.00 29.20 29.10 29.10 - -
Incidence Hepatitis/100,000 40,310 53.30 48.50 65.00 34.80 19.10 22.20 16.80Incidence Gonorrhea/100,000 40,322 46.10 33.50 29.10 20.30 17.10 14.80 12.00 _SDR Car Accidents/100,000 110,201 21.70 23.20 23.10 21.70 21.10 21.70 22.50 _Fatalities-Work Accidents/1 00,000 110,503 4.40 3.40 3.60 2.90 2.40 2.10 2.10 _SDR Suicide+Self Injury/100,000 120,101 31.00 32.30 34.50 27.90 32.10 28.80 30.10 _Nutriton
% Of Total Energy From Fat 160,306 - - - 36.60% - - - _% Of Total Energy From Protein 160,307 _ _ _ - _ | _ _% Of Total Energy From Alcohol 160,308 - -- - _- -
% Neonates Weighing More Than 2500g 160,401 94.10% 94.30% 94.40% 94.80% 94.50% 94.20% 94.50% _Annual Liters Alcohol/Person 170,101 11.40% 10.90% 92.00% 10.20% 92.00% 11.30% 93.00% _Annual Cigarette Consumpton/Person 170,902 _- - - - - - -
Nonsmokers In Population (%) 171,001 - 65.90% _ 64.00% - - _ 71.90%0-
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 _ - - - 89.50% - -Urban 200,108 _- - 94.90% - _Rural 200,109 _- - 84.00% - _ _
% Population With Water Supply In HomeTotal 992,001 _ _ - 100.00% - _ _Urban 992,002 _ _ _ - 100.00% - _ _Rural 992,003 __ _ _ - 100.00% - _ _
TABLE 24B. SLOVENIA: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFARefs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Personnel Per 100,000 PopulationDoctors 270,201 200.40 202.40 206.30 205.50 207.90 209.10 203.10 -- --Qualified nurses 270,202 553.00 590.60 559.00 561.30 546.80 562.80 590.10 Dentists 270,203 54.70 55.60 56.90 56.40 52.00 52.80 48.60 Pharmacists 270,204 45.60 48.20 31.50 32.60 30.00 23.60 35.90 Midwives 270,209 - -- 36.50 33.50 -- -- --
% Doctors Working In Hospitals 270,321 46.40% 48.70% 47.20% 46.30% 47.90% 47.50% 49.80%% Nurses Working In Hospitals 270,322 55.10% 66.10% 60.90% 63.50% 58.80% 61.10% 57.00%
Graduating Per 100,000 PopulationDoctors 360,301 6.90 6.70 5.60 7.30 5.30 5.30 6.20Nurses 360,302 47.70 34.10 29.70 32.80 36.30 50.10 48.30Dentists 360,303 0.90 1.60 1.30 1.90 1.50 1.30 1.60Pharmacists 360,304 2.30 0.00 2.50 3.10 3.00 3.00 3.10Midwives 360,305
Health UnitsPrimary Care Units/100,000 Population 270,206 1.00 1.00 1.00 1.00 1.00 3.00 4.00Hospitals/100,000 Population 270,210 1.10 1.10 1.10 1.15 1.15 1.15 1.21Inpatient Beds/100,000 population 992,710 540.00 530.00 530.00 520.00 520.00 510.00 500.00 _Psychiatric Beds/100,000 Population 992,711 78.00 81.00 81.00 81.00 81.00 79.00 78.00 _Nursing Home Beds/100,000 Populabon 992,712 -- - -- -- -- ---
Utilization% Children Immunized Against:
Diptheria 280,101 95.90% 96.70% 96.30% 97.80% 97.90% 98.50% 98.00% oTetanus 280,102 95.90% 96.70% 96.30% 97.80% 97.90% 98.50% 98.00%Pertussis 280,103 94.40% 95.10% 95.20% 97.10% 97.30% 97.70% 98.00% lMeasles 280,104 91.00% 90.90% 90.60% 92.30% 90.60% 90.30% 98.70%Polio 280,105 94.40% 95.30% 95.10% 96.80% 97.60% 98.30% 98.00%Tuberculosis 280,106 92.00% 93.70% 94.30% 94.30% 87.00% 92.50% 96.00%
Abortions/1,000 Live Births 280,500 661.00 650.30 671.90 651.30 648.70 663.10 616.50Ambulatory Care Contacts/Person 992,801 -- -- -- - -- -- --
Inpatient Admissions/100 Population 992,902 16.00 15.90 15.90 15.70 15.10 15.70 15.80Average Length Of Stay (Days) 992,901 12.00 11.60 11.40 11.30 11.00 10.90 10.90
QualitySDR Appendicitis/100,000 Population 310,304 0.64 0.28 0.31| 0.10 0.30 0.60 0.46SDR Drug Reactions/100,000 Population 310,306 0.06 0.00 0.14 0.00 0.20 0.20 0.11Surgical Wound Infection Rate 310,701 -- I -- -- -- -- .-- --
TABLE 24A. SLOVENIA: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status HFA Refts 1987 1988 1989 1990 191 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 26.50 4.30 7.4 4.70 1.60 0.50 0.40 - -Malaria 50,112 0.20 0.10 0.50 0.50 0.10 0.20 0.30 - -Diphtheria 50,113 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -Tetanus 50,114 -0.30 0.60 0.70 0.50 0860 0.50 0.40 - -Acute Poliomyelitis 50,115 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -NeonatalTetanus 50,118 0.00 0.00 0.00 0.00 0.00 0.00 0.00 - -Rubella 50,130 405.20 583.20 265.10 92.50 340.10 26.40 10.10 - -Mumps 50,131 15.40 17.90 19.90 8.90 6.60 4.90 4.70 - -Clinically Diagnosed AIDS 50,312 0.05 0.10 0.40 0.10 0.40 0.20 0.40 - -
Life ExpectancyAt Birth, In Years 60,101 72.10 72.30 72.80 73.30 73.35 73.45 73.35 74.10 -At Age 1, In Years 60,201 71.95 72.00 72.45 72.90 73.10 73.00 72.90 - -AtAge 15, InYears 60,202 58.25 58.35 58.75 59.10 59.75 59.20 59.10 - -AtAge 45, In Years 60,203 30.10 30.10 30.55 30.85 30.95 30.95 30.95 - -AtAge 65, In years 60,204 14.45 14.55 14.80 14.95 14.95 15.00 15.25 - -Probability Of Dying Before 5 yrs /1,000 Population 60,401
IntantMortalityl1,000 Live Births 70,100 11.10 10.00 8.10 8.40 8.30 8.90 6.80 6.47 -Matemal Deaths/100,000 Live Births 80,100 3.90 11.80 4.20 8.80 4.60 5.00 5.07 - -
Standard Death Rates Per 100,000 PopulatonCirculatory, All Ages 90,102 505.90 477.40 426.40 439.50 442.30 415.60 436.10 _ _Malignant Neoplasms, All Ages 100,102 207.50 210.20 209.50 211.30 219.90 221.20 226.90 _Alt Causes, All Ages 990,102 1035.50 989.40 960.80 936.10 963.90 953.80 974.60 _Infectious/Parasific, All Ages 993,002 8:00 7.20 8.50 5.70 6.20 6.20 4.90 _Respiratory System, All Ages 993,202 43.10 45.20 73.60 57.70 54.30 58.50 57.90 _MentaVNervous/Sensory; All Ages 993,702 9.80 8.90 7.50 8.50 9.30 9.20 9.20 _
Crude Birth Rate (Per 1,000 Population) 998,004 12.90 12.70 11.80 11.30 10.80 10.00 9.90 9.79Crude Death Rate (Per 1,000 Population) 998,005 9.40 9.60 9.30 9.30 9.70 9.70 10.10 9.73Total Fertility Rate 998,008 - - 1.52 1.46 1.42 1.34 1.31 -
TABLE 25A. TURKMENISTAN: HEALTH STATUS AND HEALTH SERVICES, LIFESTYLES AND HEALTHY ENVIRONMENT
Health Status And Health Services HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Lifestyles
Incidence Tuberculosis/100,000 40,301 59.00 -- 47.00 43.80 43.60 43.20 -- - --Incidence Hepatitis/1 00,000 40,310 47.50 - 48.40 59.60 - 33.10 ---
Incidence Gonorrheali 00, 000 40,322 3.10 ----.-- - --SDR Car Accidents/1 00,000 110,201 _ - - - - -_ Fatalities-Work Accidents/1 00,000 110,503 2.20 _ 2.60 2.80 2.80 3.00 _SDR Suicide+Self Injury/100,000 120,101 - -- - - -
Nutrition% Of Total Energy From Fat 160,306 23.10% 24.10% 24.30% 25.00% 24.00% 24.30%% Of Total Energy From Protein 160,307 10.80% 10.90% 10.60% 10.50% 11.60% 11.70% _% Of Total Energy From Alcohol 160,308 0.05% 0.05% 0.05% 0.05% --
% Neonates Weighing More Than 2500g 160,401 -- - -- - --
Annual Liters Alcohol/Person 170,101 0.60 0.40 0.50 0.70 0.80 - --
Annual Cigarette Consumption/Person 170,902 1444.20 1263.50 1311.50 1429.70 1311.30 1406.80 l
Nonsmokers In Population (%) 171,001 0.57 0.56 -- 0.56 - -- --
Healthy Environment
% Population With Access To Hygienic Sewage DisposalTotal 200,107 - -- 94.40% - _ l
Urban 200,108 - 99.00% _ _ l
Rural 200,109 - - 90.00% _ X --
% Population With Water Supply In HomeTotal 992,001 - - - _ _ _Urban 992,002 - _ _Rural 992,0031 - _ _ _ _
TABLE 25B. TURKMENISTAN: HEALTH STATUS AND HEALTH SERVICES, APPROPRIATE CARE
Appropriate Care HFA Refs 1987 1988 1989 1990 1991 1992 1993 1994 1995
Medical Peronnel Per 100,000 PopulationDoctors 270,201 352.74 354.73 340.23 361.37 367.28 358.87 356.98 353.24 -Qualified nurses 270,202 - - -- - -- -- _ -
Dentists 270,203 _ _ _ _ _Pharmacists 270,204 _ _ _ _ _Midwives 270,209 _ _ _ _ _
% Doctors Working In Hospitals 270,321 _ _ _ _% Nurses Working In Hospitals 270,322 - - - - --
GraduaUng Per 100,000 PopulationDoctors 360,301 5.60 - 7.10 8.10 8.10 _ _Nurses 360,302 2.20 - 3.40 4.00 4.90 -- Dentists 360,303 1.20 - 1.30 1.30 1.20 1.30 _ _Pharmacists 360,304 1.20 - 1.20 1.30 1.40 - _Midwives 360,305 - - 4.10 5.10 5.50 _ | _
Health UnitsPrimary Care Units/100,000 Population 270,206 -- -- -- - - -Hospitals/100,000 Population 270,210 1.50 1.50 1.60 1.60 1.60 _ _Inpatient Beds/100,000 population 992,710 210.00 210.00 210.00 210.00 240.00 --Psychiatric Bedsl 0D,D00 Population 992,711 10.00 10.00 10.00 10.00 - _ _ _Nursing Home Beds/100,000 Population 992,712 -- -- - - - - --
Utilization t
% Children Immunized AgainstDiptheria 280,101 71.00% 68.00% 74.00% 74.00% 72.00% 68.00% 65.00% _Tetanus 280,102 71.00% 68.00% 74.00% 74.00% 72.00% 68.00% 65.00%Pertussis 280,103 71.00% 68.00% 74.00% 74.00% 72.00% 68.00% 65.00%Measles 280,104 50.00% 59.00% 67.00% 68.00% 66.00% 65.00% -Polio 280,105 71.00% 68.00% 74.00% 74.00% 72.00% 62.00% 65.00% _Tuberculosis 280,106 34.00% 15.00% 16.00% 16.00% 53.00% 59.00% 59.00%
Abortions/1,000 Live Births 280,500 - - - - - -- --Ambulatory Care Contacts/Person 992,801 - -- -- -Inpatient Admissions/1 00 Population 992,902 5.50 5.40 5.60 5.60 _Average Length Of Stay (Days) 992,901 7.10 6.90 6.80 6.90 _ _ _
QualitySDR Appendicitis/100,000 Population 310,304 _ - -_ _ _ _ SDR Drug Reactions/100,000 Population 310,306 _ _ _ _ _ _ _Surgical Wound Infection Rate 310,701 _ _ _ .
TABLE 25C. TURKMENISTAN: HEALTH STATUS AND HEALTH SERVICES, HEALTH STATUS
Heah Status |HFARefs| 1987 1988 1989 1990 19911 1992 1993 1994 1995
Incidence, Cases Per 100,000 PopulationMeasles 50,111 4.20 - 34.00 20.40 39.00 41.80 58.10 -
Malaria 50,112 38.90 - 21.30 15.50 21.20 31.70 - -
Diphtheria 50,113 0.10 - 0.00 0.00 0.00 0.00 0.10 -
Tetanus 50,114 0.20 - 0.20 0.20 0.20 0.20 0.20 -
Acute Poliomyelitis 50,115 0.00 - 0.00 0.00 0.10 0.00 0.00 -
Neonatal Tetanus 50,118 0.10 - 0.10 0.10 0.10 0.00 0.10 _Rubella 50,130 - - - - - - - -
Mumps 50,131 - - - - - - - -
Clinically Diagnosed AIDS 50,312 0.00 - 0.00 0.00 0.00 0.00 0.10 -
Life ExpectancyAt Birth, In Years 60,101 65.20 65.10 65.10 66.50 65.50 66.40 64.20 63.90AtAge 1, In Years 60,201 - - - - - - - -
At Age 15, In Years 60,202 - - - - _ _ | _At Age 45, In Years 60,203 - - - - - - - -
At Age 65, In years 60,204 - - - - - - - -
Probability Of Dying Before 5 yrs 11,000 Population 60,401 - - - - - - - -
Infant Mortality/1,000 Live Births 70,100 56.40 53.30 54.70 45.20 47.00 43.60 45.90 -
Matemal Deaths/100,000 Live Births 80,100 48.11 33.60 59.20 42.28 45.94 58.00 42.70 42.93
Standard Death Rates Per 100,000 PopulationCirculatory, All Ages 90,102 - - - - - - - - _Malignant Neoplasms, All Ages 100,102 - - - - - - - -
All Causes, All Ages 990,102 _ - - - - - - -
Infectious/Parasitic, All Ages 993,002 - - - - - - - -_Respiratory System, All Ages 993,202 - - _ _ _ _ | _MentalNervous/Sensory, All Ages 993,702 - - - - - - - -
Crude Birth Rate (Per 1,000 Population) 998,004 37.20 36.00 35.00 34.20 33.60 34.00 33.10 34.76Crude Death Rate (Per 1,000 Population) 998,005 7.90 7.80 7.70 7.00 7.30 7.10 8.20 7.93Total Fertility Rate 998,006 - - 3.60 3.50 3.40 3.40 3.90 -_
-101 -
CHAPTER III: FIGURES
Table of Contents
Figure 1. Life Expectancy at Birth by Country, 1989 and 1993 (males) ....................................... 103
Figure 2. Age-Standardized Death Rates by Selected Causes in 1993 (Europeanstandard population) ................................................ 104
Figure 3. Infant Mortality Rate (IMR) by GDP per Capita for FSEs in 1993 ................................ 105
Figure 4. Infant Mortality Rates (IMR) by GDP Per Capita for EMEs in 1993 ............................ 106
Figure 5. Life Expectancy by GDP Per Capita for Males in FSEs and EMEs in theEarly 1990s .107
Figure 6. Life Expectancy by GDP per Capita for Females in FSEs and EMEs in theEarly 1990s ........................................................ 108
Figure 7. 50q15 by GDP per Capita for Males in FSEs and EMEs in the Early 1990s ................. 109
Figure 8. 50q 15 by GDP per Capita for Females in FSEs and EMEs in the early 1990s .............. 110
Figure 9. 50Oq 5 and Infant Mortality Rate (IMR) in FSEs and EMEs in the Early 1990s ............ 111
Figure 10. Percentage Changes in Annual Cigarette Consumption/Person by Country,1987-1992 ......................................................... 112
Figure 11. Changes in Abortions and Maternal Deaths in Romania, 1987-1993 ............................. 113
Figure 12. Immunization Coverage and Incidence of Measles in FYR Macedonia, 1987-94 ......... 114
Figure 13. Public Sector Health Expenditures as a Percent of Gross Domestic Product by GDPper Capita (1993) ................................................. 115
Figure 14a. Public Sector Health Expenditures as a Percent of GDP (1987-1994) ........................... 116
Figure 14b. Public Sector Health Expenditures as a Percent of GDP (1987-1994) ........................... 117
Figure 15. Reduction in Real Public Spending for Health (1990-1993) .......................................... 118
Figure 16a. Evolution of Real Spending (1990-1994) Total Health Expenditures ............................ 119
Figure 16b. Evolution of Real Spending (1990-1994) Total Health Expenditures ............................ 120
Figure 17a. Evolution in Real Spending (1990-1994) Personnel Expenditures ................................ 121
-102-
Figure 17b. Evolution in Real Spending (1990-1994) Personnel Expenditures ................................ 122
Figure 18a. Evolution in Real Public Spending (1990-1994) Drug Expenditures ............................. 123
Figure 18b. Evolution of Real Public Spending (1990-1994) Drug Expenditures ............................. 124
Figure 19a. Evolution of Real Public Spending (1990-1994) Capital Expenditures ......................... 125
Figure 19b. Evolution of Real Public Spending (1990-1994) Capital Expenditures ......................... 126
Figure 20. Breakdown of Recurrent Public Spending for Health (1993) ......................................... 127
Figure i: Life Expectancy at Birth by Country, 1989 and 1993 (males)
70
68
.~66
> 64 -
* r~~~~1993
[007 1989
a62~xLu
60
58
E 0 .0E
E . 0 .~0
U)~~C
Figure 2: Age-Standardized Death Rates by Selected Causes in 1993(European standard population)
800
700
0 0
'U;
D00
Circulatory system
00
Jschemic heart disease
100 S
L 7 ; Crebro-vascular disease
Lung cancer.D X , D X $=
Liver
cirrhosisn ~~~~~~6 ~~~~~~
m~~~ sU : o
N(Albania data from 1992, USA from 1991)
Figure 3: Infant Mortality Rate (IMR) by GDP Per Capita forFSEs in 1993
35
*Albania
30
_ * FYRM
.~25
* t 25 \ -+ ~~Romania-
.> 20 Russia
O ~~~~~~~~~~~~~~~Ukraine
15 . ~~~~~~~~~~~Pioland. o HungaryCL~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~U
EQ lo Slovakia*Crai*Czech Rep.
5
o.0
0 500 1000 1500 2000 2500 3000 3500 4000
1993 GDP Per Capita
Figure 4: Infant Mortality Rates (IMR) by GDP Per Capita for EMEs in1993
12 Korea
"10 *
t USA
00
o) Spain* * *> ~~~~~~~~~~~~~~~~~~~Switzerland
@ 6 ~~~~~~~~~~~~Germ,any
tn ~~~~~~~~Finland *Sweden
CO 4*D ~~~~~~~~~~~~~~~~~Japan
a.
C 2(0' 0. IIII
0 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000
1993 GDP Per Capita
Figure 5: Life Expectancy by GDP Per Capita for Males inFSEs and EMEs in the Early 1990's
78 78
* *Japan76 USA 76
Greece * *_74 Denem a k 74
WL 72 | 72 E
70 *Portugal 70
Armenia PolandCD68 68u
* ~~ A
x 66 ~~~~~~~~~~~66 xW Hungary W
64. 4*-64 6
* ^ UkraineA A62 62
A FSE _ _60 60
Russia EME -A
58 580 500 1000 1500 2000 2500 3000 3500 4000
Multiply by a factor of 10 for GDP Per Capita of EMEs
Figure 6: Life Expectancy by GDP Per Capita for Females inFSEs and EMEs in the Early 1990's
84 84Japan *
82 U82
LlJ 80 Greece a SA 80 lJ
LL Denmark LU
>% 78 Portugal 78 >,
A ~~~~~~~~~~~~~A zD 76 Annenia Poland 760. ~~~Armenia 0.
LU A A A uli* A
14 - - A~~~~~~ -- 74Xl 74 m - - - m - - - - m - - m m - A Russia A A
Hungary
Ukraine A72-A 72
A FSE -
EME
70 l I I l 700 500 1000 1500 2000 2500 3000 3500 4000
Multiply by a factor of 10 for GDP Per Capita of EMEs
Figure 7: 50q15 by GDP Per Capita for Males inFSEs and EMEs in the Early 1990's
60--...... 60FSE -
55 EME A Russia 55
A
50 - 50D- LU'
v vUkraine , - w
45 A A Hungary A 450 - 0
.... . ,,
00~~~~~~~~0$ 40 ,0 40 )1t0 - - CD*- - S._
. 35 - - - A Poland 35 0
0 , ' * - =I, v - -A.00- A A30 - Armenia * 30
A 0c
25 USA 25 LO- *U* " " Denmark
20 A * - 20Greece a Jipan
15 150 500 1000 1500 2000 2500 3000 3500 4000
Multiply by a factor of 10 for GDP Per Capita of EMEs
Figure 8: 50q15 by GDP Per Capita for Females inFSEs and EMEs in the Early 1990's
24 24FSEEME -A
22 A 22Hungary
A20 *Ukraine A 20
A A
18 A 1-8 ll
16 16Armenia A Poland v10 ~~~~~~~~A A I
USA~~C 14 AUSA A 14 CL
12 Portugal 12
10 A a 10
Greece*8 Japan* 8
6 60 500 1000 1500 2000 2500 3000 3500 4000
Multiply by a factor of 10 for GDP Per Capita of EMEs
Figure 9: 50q15 and Infant Mortality Rate (IMR) inFSEs and EMEs in the Early 1990's
60
55 * Russia
* Latvia
50 Hungary
* Estonia Kazakhstan45 Lithuania * tBelarus
uD 40 _
40
35 * Poland35
Slovenia Bulgaria Uzbekistan* A~~~1rmenia
30 tzech Tajikistan
25
Albania
20-:0 5 10 15 20 25 30 35 40 45 50
IMR per 1,000 live births
Figure 10: Percentage Change in Annual Cigarefte Consumption/Person byCountry, 1987 - 1992
250
200 - -0
0.
E 150 _ _--_--_------ --._--_----___ ---- --------o- Albania
o /4- Bulgaria
-a Czech2 100 . -- Hungary
C, /~- Poland
Xu /j-- Romania
-0- Slovakia
(A
0
-50
1987 1988 1989 1990 1991 1992
Figure 11: Changes in Abortions and Maternal Deaths in Romania, 1987 -1993
3500 180
1603000
140
2500
120
0 CD~~~~~~~~~~~~~~~~~
a0 > > ~ ~~~~ - _-Matema
0 2000 1 E
500
e 5~~~~~~~~~~~~~~~~~~~~~~~~. | AAborios/i.0
.0 0
1987 1988 1989 1990 1991 1992 1993
Figure 12: Immunization Coverage and Incidence of Measles in FYR Macedonia,1987 - 1994
100 250
90 /
80 | 200
70-
/ ~~~0
60 1500.o I l l l lo 0
1987 1988 1989 1990 1991 1992 1993 1994en
0.
c 5Q ImmunizedE 50E -Incidence
OA ~~~~~~~~~~~~~~~~~~~~~~~~~~~~.per 100,000
40 -- 100 (3POP.
30 -
20 - 4I -50O/~~~~~~10~~~~~~~~~~~~~~
10 I
1987 1988 1989 1990 1991 1992 1993 1994
Figure 13: Public Sector Health Expendituresas a Percent of GDP by GDP Per Capita (1993)
12%
10%
8%CzcFYRM Croatia h
,_ 6% * Slovakia Slovenia
0 Bulgaria* Poland
4% * Lithuania
* * Romanialbania
2%* Turkmenistan
0% I I
0 1000 2000 3000 4000 5000 6000 7000
1993 GDP per capita (US$)
Figure 14a: Public Sector Health Expenditures as a Percent of GDP (1987-1994)12%
10%r
8 % -- - - -- - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -_ _ _ - - - - - - - - - - - -_-_- -_
-u Croatia
-fr Cech
I-a- Hungary5 % -]-------------------- ----------- FYRM
0 ~~~~~~~~~~~~~~~~~~~~~~~~~~~-Slovakia-0- Slovenia
2%-
0%
1987 1988 1989 1990 1991 1992 1993 1994Year
Figure 14b: Public Sector Health Expenditures as a Percent of GDP (1987-1994)12%
1n% ------------------------------------------------------------ ___________
8%
--.-- Albania
-X-. Bulgaria
, -- Poland
0 -o- Romania
--wI Lithuania
-4o-| Turkmenistan
2%;
0% -
1987 1988 1989 1990 1991 1992 1993 1994
Year
Figure 15: Reduction in Real Public Spending for Health(1990 - 1993)
65 Lithuania
55 Albania
0~ ~~~~5
CM 45
It e iturmnsan
, - 35 ~~~~~~~Bulgaria °0
.° ~~~~~~~~~~~~FYRM0 25 - Slovakia
n * ~~~~~~~~~~~~~~~~~ ~~~CroatiaCzech Hu gary
Ne * Rmania
Poland
~I * I _ p
-15 -5 5 15 25 35 45 55 65
% Reduction in Health Spending
Figure 16a: Evolution of Real Spending (1990-1994)Total Health Expenditures
140
120 -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - - - /-- - - - - -
100 1 ------
C
e 80 -- Bulgaria
CO ~~~~~~~~~~~~~~~~~~~~~~~aCzechHungary
-s60 Poland
x ~~~~~~~~~~~~~~~~~~~~~~~~~--Romania0c +O-- Slovakia
01990 1991 1992 1993 1994
1990 = 100
Figure 16b: Evolution of Real Spending (1990-1994)Total Health Expenditures
140
1 2 0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
.S ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-o-- Albaniala.con
\ x FYRM
-a-a Lithuaniax -r-- Turkmenistan
40 1 : 1
01990 1991 1992 1993 1994
1990 = 100
Figure 17a: Evolution in Real Spending (1990-1994)Personnel Expenditures
130
1201
110 - - - - - - - - - - --- _- - - - - - - - - - - - - - - - - - - - --_-_- -_- - --_- - - - - _- _-_-- - -c0
/L /_-- Bulgaria
Czech
* -6-~~~~~~~~~~~~~~~~~~~~~~~~~~~HungaryCO ~~~~~~~~~~~~~~~~~~~~~~~~~~~--0- Romania
4) s-ol- Slovakia
x
~80-
60 I l i1990 1991 1992 1993 1994
1990 = 100
Figure 17b: Evolution in Real Spending (1990-1994)Personnel Expenditures
140
0 0
80 -\ AlbaniaCroatiaFYRM
CL -~~~~~~~~~~~~~~~~~~~~~~~~~~~~~-o- Lithuania--e- Turkmenistan
201990 1991 1992 1993 1994
1990 = 100
Figure 18a: Evolution in Real Public Spending (1990-1994)Drug Expenditures
180
160_
140 -- - -- - - - - - - - - -
.=120 ------------ ___-__ v __-_ / ----------------- \- - ---- ----- / ----------
" / Bulgaria le
1001 -- -- -- - -- -- -- -- -- ,- -- ------- -- ---- 6 Hungary
a,
o \ Romania8~~~~~~~~~~~~~~~~~~~~~~~~~~~~0 -\= +Slovenia
60 -- - - - - --- - - - - - - - - - - - - - - - - - - - - - - - - -
401990 1991 1992 1993 1994
1990 = 100
Figure 18b: Evolution in Real Public Spending (1990-1994)Drug Expenditures
250
2 0 0 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -_-- - - -_-- -_ - - - - - - - - - - - - - - - - - -
0)
1590 1991199214 -- AlbaniaCroatia
CL ~~~~~~~~~~~~~~~~~~~*FYRM-c-Lithuania
100 ~~~~~~~~~~~~~~~~~~~~~~~~~-0- Turkmenistan
*0
0
1990 1991 1992 1993 1994
1990 = 100
Figure 19a: Evolution in Real Public Spending (1990-1994)Capital Expenditures
120'
90 ----- ------- ---------------- ~~~~~~~~~~~~-.-Bulgaria-uCzech
af \Hungaryr- 80 --------- ------------ ------ --------- - x- Poland
S
40
1990 -1991 1992 1993 19941990 = 100
Figure 19b: Evolution in Real Public Spending (1990-1994)Capital Expenditures
160
12~~~~~~~~~~~~~~~~~~~~~~~~~0-A lba
} k ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~A-| Croatial
n \ 1 \s /~~~~~~~~~~~~~~~~~~~~~~~~~~b Lithuania 1480 -------------- --------------------------------------------- T urkm enistan |_ 0-1 ----------- ---- >>---------------- -- 1 lai
4 0 -- _-_- - - - ------------------------- ----------------- --- - -- -- ---- - -- -- ---- -- Turmensta0x
0
1990 1991 1992 1993 19941990 = 100
% of Recuirrent Public Spending
-& N)~~~~ Ca b. C?' 0) -j co CD 0o 0 0) 0D 0 0 0 0 0 0 00-0 -.O e O0
FYR Mac. UfEVE M_
Turkmenistan f1in WE 5 U
Lithuania -~ u w m
Bulgaria
Poland CD
CL
Hungary to
Czech Republic |°LzI~~~~~~~~~~-
Slomenia C
CD~ ~ ~ ~0~~~~~~~~C
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GLOSSARY
Definitions of Macroeconomic Indicators
Deflated GDP Real GDP in 1990 currency.
Deflated total expenditures Total expenditures divided by the GDP deflator.
GDP (Gross Domestic Product) The sum of the value of goods and services produced within a countryin nominal terrns.
GDP deflator The index of inflation within the country.
Population Total population within the country.
Total expenditures The sum of all government expenditures within a particular country.
Definitions of Fiscal Indicators
Capital expenditures Expenditures on the construction of new and rehabilitation of old buildings, andthe purchase of equipment and vehicles.
Deflated health expenditures (1990=100) Health expenditures divided by the GDP deflator, indicatingthe change in expenditures by category in real local currency.
Expenditure allocation The classification of hospital and non-hospital activities, with the hospitalcategory classified into in-patient and out-patient sub-categories.
Medical education A range of activities, from training researchers, to the provision of retraining formidwives.
Personal health services A category including personnel (wages and benefits), drugs, otherconsumables/supplies, energy (heating and lighting), maintenance, transportation (official business trips)and "other" expenditures, which do not fall clearly into any of the previous categories.
Private expenditures The sum of private out-of-pocket expenditures and reimbursement by privateinsurance institutes.
Private revenues The sum of private insurance and direct charges levied by private health institutions.
Public expenditures The sum of recurrent expenditures, capital expenditures and reimbursement by thepublic insurance institutes to private sector doctors and institutions.
Public health activities Red Cross related activities as well as pest and rodent control.
Public revenues The sum of state budget (central government, district and local), national healthinsurance, drugs, direct charges levied by government health institutions, borrowing and foreignassistance.
Recurrent expenditures A classification including personal health services, such as hospitalization andvisits to doctors, and non-personal health services such as public health activities, medical education andresearch and development.
Total health expenditures The sum of public and private expenditures.
Total health revenues The sum of public and private revenues.
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Definitions of Epidemiological and Demographic Indicators
Abortion rates = (Number of abortions/total live births)* 1,000.
Annual alcohol consumption Measured in litres per person.
Annual cigarette consumption = ((Number of cigarettes produced + Number of cigarettes imported) -number of cigarettes exported)/Population.
Average length of stay (ALOS) = (Annual number of inpatient days/Annual number of admissions ordischarges).
Crude Birth Rate = (Number of births/Population)* 1,000.
Crude Death Rate = (Number of deaths/Population)* 1,000.5 0q15 = ((Number of survivors to age 15-Number of survivors to age 65)/Number of survivors to age15)* 100. This function is the numerical answer to the question: among persons who reach the exact age15, what proportion will die before their 65th birthday, i.e., within 50 years? It is based on period/cross-sectional life tables, a mathematical model of the life history of a hypothetical cohort.
Immunization Coverage = (Number of children immunized in an age group/Total number of children inthe age group)* 100.
Incidence of low birth weight neonates = (Number of births weighing less than 2,500 grams/Total livebirths)* 100.
Incidence rates The number of new events or cases of disease that develop in a population ofindividuals at risk during a specified time interval. In this study, the time interval is the given year.Incidence rates for the various diseases such as tuberculosis and hepatitis are measured per 100,000persons. The same is the case for car accidents, suicides and work accidents.
Infant Mortality Rate (IMR) = (Total infant (i.e. under 1 year of age) deaths/Total live births)* 1,000.
Inpatient admissions Expressed per 100 population.
Life expectancy The quotient of the total number of years lived after a given age (at birth, age 1, etc.)and the number of persons who survived to attain that given age.
Maternal Mortality Ratio (MMR) = (Total deaths of mothers during delivery or due to pregnancy-related causes/total live births)* 100,000.
Medical personnel Doctors and nurses are expressed per 100,000 population, as are the number ofmedical and other health related graduates each year. The number of doctors and nurses working in thehospitals is expressed as a percentage of all doctors and nurses working within the country.
Standardized Death Rates (SDR) Expressed in terms of 100,000 people for various causes.Circulatory includes all deaths associated with the circulatory system, malignant neoplasm refers todeaths from cancers of all kinds; infectious/parasitic: include deaths from diseases such as malaria:respiratory system: refers to deaths from diseases such as asthma; and mental and nervous system: refersto diseases related to brain and the nervous system. SDRs from appendicitis are expressed as aproportion of 100,000, population as are SDR drug reactions and surgical wound infection rates.
Total fertility rate The number of children a woman would have if she passed through her childbearingyears and experienced at the current age-specific fertility rates.
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RECENT WORLD BANK TECHNICAL PAPERS (continued)
No. 307 Narayan, Toward Participatory Research
No. 308 Adamson and others, Energy Use, Air Pollution, and Environmental Policy in Krakow: Can Economic Incentives Really Help?
No. 309 The World Bank/FOA/UNIDO/Industry Fertilizer Working Group, World and Regional Supply and Demand Balancesfor Nitrogen, Phosphate, and Potash, 1993/94-1999/2000
No. 310 Elder and Cooley, editors, Sustainable Settlement and Development of the Onchocerciasis ControlProgramme Area: Proceedings of a Ministerial Meeting
No. 311 Webster, Riopelle and Chidzero, World Bank Lendingfor Small Enterprises 1989-1993
No. 312 Benoit, Project Finance at the World Bank: An Overview of Policies and Instruments
No. 313 Kapur, Airport Infrastructure: The Emerging Role of the Private Sector
No. 314 Valdes and Schaeffer in collaboration with Ramos, Surveillance of Agricultural Price and Trade Policies: A HandbookforEcuador
No. 316 Schware and Kimberley, Information Technology and National Trade Facilitation: Making the Most of Global Trade
No. 317 Schware and Kimberley, Information Technology and National Trade Facilitation: Guide to Best Practice
No. 318 Taylor, Boukambou, Dahniya, Ouayogode, Ayling, Abdi Noor, and Toure, Strengthening National Agricultural ResearchSystems in the Humid and Sub-humid Zones of West and Central Africa: A Frameworkfor Action
No. 320 Srivastava, Lambert and Vietmeyer, Medicinal Plants: An Expanding Role in Development
No. 321 Srivastava, Smnith, and Forno, Biodiversity and Agriculture: Implicationsfor Conservation and Development
No. 322 Peters, The Ecology and Management of Non-Timber Forest Resources
No. 323 Pannier, editor, Corporate Governance of Public Enterprises in Transitional Economies
No. 324 Cabraal, Cosgrove-Davies, and Schaeffer, Best Practicesfor Photovoltaic Household Electrification Programs
No. 325 Bacon, Besant-Jones, and Heidarian, Estimating Construction Costs and Schedules: Experience with Power GenerationProjects in Developing Countries
No. 326 Colletta, Balachander, Liang, The Condition of Young Children in Sub-Saharan Africa: The Convergence of Health,Nutrition, and Early Education
No. 327 Valdes and Schaeffer in collaboration with Martin, Surveillance of Agricultural Price and Trade Policies: A HandbookforParaguay
No. 328 De Geyndt, Social Development and Absolute Poverty in Asia and Latin America
No. 329 Mohan, editor, Bibliography of Publications: Technical Department, Africa Region, July 1987 to April 1996
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No. 333 Jha, Ranson, and Bobadilla, Measuring the Burden of Disease and the Cost-Effectiveness of Health Interventions: A Case Studyin Guinea
No. 334 Mosse and Sontheimer, Performance Monitoring Indicators Handbook
No. 335 Kirmani and Le Moigne, Fostering Riparian Cooperation in International River Basins: The World Bank at Its Best inDevelopment Diplomacy
No. 336 Francis, with Akinwumi, Ngwu, Nkom, Odihi, Olomajeye, Okumnadewa and Shehu, State, Community, and LocalDevelopment in Nigeria
No. 338 Young, Measuring Economic Benefitsfor Water Investments and Policies
No. 339 Andrews and Rashid, The Financing of Pension Systems in Central and Eastern Europe: An Overview of Major Trends andTheir Determinants, 1990-1993
No. 340 Rutkowski, Changes in the Wage Structure during Economic Transition in Central and Eastern Europe
No. 341 Goldstein, Preker, Adeyi, and Chellaraj, Trends in Health Status, Services, and Finance: The Transition in Central andEastern Europe, Volume I
No. 343 Kottelat and Whitten, Freshwater Biodiversity in Asia, with Special Reference to Fish
No. 344 Klugman and Schieber with Heleniak and Hon, A Survey of Health Reform in Central Asia
No. 345 Industry and Mining Division, Industry and Energy Department, A Mining Strategyfor Latin America and the Caribbean
No. 347 Stock and de Veen, Expanding Labor-based Methodsfor Road Works in Africa
No. 350 Buscaglia and Dakolias, Judicial Reform in Latin American Courts: The Experience in Argentina and Ecuador
No. 353 Ingco, Mitchell, and McCalla, Global Food Supply Prospects: A background paper preparedfor the World Food Summit, Rome,November 1996
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