Abstract
OBJECTIVE: To assess the health care and health status of patients attending primary care clinics in Bosnia and Herzegovina. DESIGN: Assisted administration patient survey. SETTING: Two ambulatory care clinics (ambulantas) in each of three cities in Bosnia and Herzegovina: Tuzla, Mostar, and Banja Luka. PARTICIPANTS: Patients attending the ambulantas during a 1-week period in March 1999; 885 answered questionnaires. MAIN OUTCOME MEASURES: Each patient listed demographic characteristics and answered questions on satisfaction with health care and with the physical and financial accessibility of health care services and medications. A validated health status questionnaire (EuroQoL), previously used in parts of the former Yugoslavia, was administered. RESULTS: Only 22% of patients were employed; 57% could not pay the nominal fee to see a physician; 71% walked to the clinic; mean distance from patients' homes to the clinics was 2.3 km; 63% could not get the medications prescribed (in 85% of cases because of cost, not availability); 80% to 90% of answers to satisfaction questions suggested high satisfaction with the care patients received from their doctors; 67% of the time patients were referred to a specialist by general practitioners; 33% had problems walking; 17% had problems with self-care; 36% had problems with usual daily activities; 72% had at least some pain or discomfort; and 62% described at least some anxiety or depression. The three cities showed significant differences; patients in Tuzla generally had lower health status and more problems with health care. CONCLUSION: Unemployment and financial considerations reduced health care access in Bosnia and Herzegovina. While only one third of patients had physical difficulties, two thirds had emotional problems or pain. Satisfaction with physicians' care was high.
Full Text
The Full Text of this article is available as a PDF (116.5 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Acheson D. Health, humanitarian relief, and survival in former Yugoslavia. BMJ. 1993 Jul 3;307(6895):44–48. doi: 10.1136/bmj.307.6895.44. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Alderslade R., Hess G., Lárusdóttir J. Sustaining, protecting and promoting public health in Bosnia and Herzegovina. World Health Stat Q. 1996;49(3-4):185–188. [PubMed] [Google Scholar]
- Brooks R. EuroQol: the current state of play. Health Policy. 1996 Jul;37(1):53–72. doi: 10.1016/0168-8510(96)00822-6. [DOI] [PubMed] [Google Scholar]
- Carballo M., Serdarevic D., Zulic I. Development of an essential drugs list for Bosnia and Herzegovina. J R Soc Med. 1997 Jun;90(6):331–333. doi: 10.1177/014107689709000610. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hakim Z., Pathak D. S. Modelling the EuroQol data: a comparison of discrete choice conjoint and conditional preference modelling. Health Econ. 1999 Mar;8(2):103–116. doi: 10.1002/(sici)1099-1050(199903)8:2<103::aid-hec393>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
- McMaster P., McMaster H. J., Southall D. P. Personal child health record and advice booklet programme in Tuzla, Bosnia Herzegovina. J R Soc Med. 1996 Apr;89(4):202–204. doi: 10.1177/014107689608900408. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sabir S., Godwin M., Birtwhistle R. Men and women residents' experiences with women's health care in a family medicine center. Acad Med. 1997 Apr;72(4):293–295. doi: 10.1097/00001888-199704000-00014. [DOI] [PubMed] [Google Scholar]
- van Agt H. M., Essink-Bot M. L., Krabbe P. F., Bonsel G. J. Test-retest reliability of health state valuations collected with the EuroQol questionnaire. Soc Sci Med. 1994 Dec;39(11):1537–1544. doi: 10.1016/0277-9536(94)90005-1. [DOI] [PubMed] [Google Scholar]