Decentralization of Mental Health Care as One of the Key Pillars of the Republic of Serbia Health Reform: The Importance of the Information Integration

Authors

  • Periša Simonović Ph.D, Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”, Dr Subotića Starijeg 5, Belgrade, Serbia
  • Snežana Svetozarević Assistant Professor, University of Belgrade, Faculty of Philosophy, Department of Psychology, Čika-Ljubina 18-20, Belgrade, Serbia
  • Snezana pavle Knezevic Professor, University of Belgrade, Faculty of Organizational Sciences, Jove Ilića 154, Belgrade, Serbia
  • Stefan Milojević Associate Professor, Educons University, Faculty of Business Economics, Vojvode Putnika 85-87, Sremska Kamenica, Serbia
  • Nebojša Zdravković Professor, University of Kragujevac, Faculty of Medical Sciences, Svetozara Markovića 69, Kragujevac, Serbia

DOI:

https://doi.org/10.52152/23.1.210-231(2025)

Keywords:

mental health care, public health, health reform, decentralization, information systems

Abstract

Healthcare system reforms are ongoing and are considered globally. However, Serbia's social, political, and economic crises have slowed progress, which started in 2002. Decentralization is regarded as critical for improving healthcare services and ensuring financial sustainability. The development of Community Mental Health Centers is considered the cornerstone of the decentralization strategy. A comparative analysis of Big Data on national public health highlights critical issues. According to our findings, it is essential to rethink the models and procedures of a review of the existing healthcare facility network and examine the local population's mental health status and health service usage. One of the appropriate procedures may be the unification and centralization of data collection and storage processes for mental health centers in the national network, both private and public. However, the decentralization processes must be balanced with centralization principles, as they are sensitive to social, historical, political, and economic influences.

References

Bjegovic-Mikanovic, V., Vasic, M., Vukovic, D., Janko, J., Jovic-Vranes, A., Santric-Milicevic, M., . . . Hernández-Quevedo, C. (‎2019)‎. Serbia: Health system review. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/331644/HiT-21-3-2019-eng.pdf?sequence=1&isAllowed=y

Brezovnik, B., Hoffman, I., & Kostrubiec, J. (Eds.). (2021). Local self-government in Europe. Institute for Local Self-Government Maribor. https://doi.org/10.4335/978-961-7124-00-2

Centar za Visoke Ekonomske Studije (CEVES) [Center for Advanced Economic Studies]. (2006). Health care system and spending in Serbia. Retrieved from https://ceves.org.rs/wp-content/uploads/2018/07/Health-Care-System-and-Spending-in-Serbia.pdf

Čudanov, M., & Jaško, O. (2012). Adoption of information and communication technologies and dominant management orientation in organisations. Behaviour & Information Technology, 31(5), 509-523. doi:10.1080/0144929X.2010.499520

Čudanov, M., Jaško, O., & Jevtić, M. (2009). Influence of information and communication technologies on decentralization of organizational structure. Computer Science and Information Systems/ComSIS, 6(1), 93-109. doi:10.2298/CSIS0901093C

Čudanov, M., Săvoiu, G., Jaško, O., & Slović, D. (2020). Performance indicator variance analysis as the statistical method for downsizing/rightsizing. Romanian Statistical Review, (3), 15-33.

Čudanov, M., Tornjanski, V., & Jaško, O. (2019). Change equation effectiveness: Empirical evidence from South-East Europe. Business Administration and Management, 22(1), 99-114. doi:10.15240/tul/001/2019-1-007

Gajić-Stevanović, M. (2015). Serbian experience with national health accounts. Frontiers in Public Health, 3, 34. doi:10.3389/fpubh.2015.00034

Gavrilović, A., & Trmčić, S. (2013). Health insurance system in Serbia–quality, reform, financial sustainability. MEST Journal, 1(2), 114-126. doi:10.12709/mest.01.01.02.11

Hlebec, V. (2017). Family care experience in a decentralized social home care context. Lex Localis - Journal of Local Self-Government, 15(3), 495-511. doi:10.4335/15.3.495-511(2017)

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. (2017). Health statistical yearbook of Republic of Serbia 2016. Retrieved from https://www.batut.org.rs/download/publikacije/pub201620180419.pdf

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. (2018). Health statistical yearbook of Republic of Serbia 2017. Retrieved from https://www.batut.org.rs/download/publikacije/pub2017v026.pdf

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. (2019). Health statistical yearbook of Republic of Serbia 2018. Retrieved from https://www.batut.org.rs/download/publikacije/pub2018.pdf

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. (2020). Health statistical yearbook of Republic of Serbia 2019. Retrieved from https://www.batut.org.rs/download/publikacije/pub2019a.pdf

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut”. (2021). Health statistical yearbook of Republic of Serbia 2020. Retrieved from https://www.batut.org.rs/download/publikacije/pub2020.pdf

Komazec, S., Todorović, I., Krivokapić, Đ., & Jaško, O. (2013). Capacities of local self-governments in Serbia for compliance with EU directives on public procurement. Management (1820-0222), 18(69), 15-24. doi:10.7595/management.fon.2013.0028

Krstić, K., Janicijevic, K., Timofeyev, Y., Arsentyev, E. V., Rosic, G., Bolevich, S., . . . Jakovljevic, M. B. (2019). Dynamics of health care financing and spending in Serbia in the XXI Century. Frontiers in Public Health, 7, 381. doi:10.3389/fpubh.2019.00381

Lecic-Tosevski, D. L., Draganic Gajic, S. D., & Pejovic Milovancevic, M. (2010). Mental healthcare in Serbia. International psychiatry: Bulletin of the Board of International Affairs of the Royal College of Psychiatrists, 7(1), 13-15. doi:10.1192/S1749367600000941

Lecic-Tosevski, D., & Milosavljevic, M. (2021). Community mental health care in Serbia: Development and perspectives. Consortium Psychiatricum, 2(2), 81-85. doi:10.17816/CP77

Marušič, D., & Prevolnik Rupel, V. (2016). Health care reforms. Zdravstveno Varstvo, 55(3), 225-227. doi:10.1515/sjph-2016-0028

Milić, N., Stanisavljević, D., & Krstić, M. (Eds.). (2021). The 2019 Serbian national health survey. Serbia: Statistical Office of Republic of Serbia. Retrieved from https://publikacije.stat.gov.rs/G2021/pdfE/G20216003.pdf

Ministarstvo zdravlja republike Srbije [Ministry of Health of the Republic of Serbija (MHRS)]. (2019). Program o zaštiti mentalnog zdravlja u Republici Srbiji za period 2019-2026. godine. Retrieved from https://www.zdravlje.gov.rs/tekst/343487/program-o-zastiti-mentalnog-zdravlja-u-republici-srbiji-za-period-2019-2026-godine-.php

Naghavi, M. (2019). Global, regional, and national burden of suicide mortality 1990 to 2016: Systematic analysis for the Global Burden of Disease Study 2016. British Medical Journal, 364, l94. doi:10.1136/bmj.l94

Popovic, N., Terzic-Supic, Z., Simic, S., & Mladenovic, B. (2017). Predictors of unmet health care needs in Serbia: Analysis based on EU-SILC data. PloS One, 12(11), e0187866. doi:10.1371/journal.pone.0187866

Richardson, E., & Bjegovic-Mikanovic, V. (2022). Health systems in action: Serbia. Retrieved from https://eurohealthobservatory.who.int/publications/i/health-systems-in-action-serbia-2022

Rogelj, A., & Brezovnik, B. (2013). Universal health services. Lex localis - Journal of Local Self-Government, 11(3), 687-708. doi:10.4335/11.3.687-708(2013)

Simović, V., & Vukša, T. (2022). When did a transition to capitalism start in Serbia?. In A. Gagyi & O. Slačálek (Eds.), The political economy of Eastern Europe 30 years into the ‘Transition’ (pp. 41-61). Switzerland: Springer Nature. doi:10.1007/978-3-030-78915-2_3

Svetozarevic, S., Vukcevic Markovic, M., Pejuskovic, B., & Simonovic, P. (2019) The guidance for protection and improvement of the mental health of refugees, asylum seekers and migrants in Serbia. Retrieved from https://kirs.gov.rs/media/uploads/4_%D0%A1%D0%BC%D0%B5%D1%80%D0%BD%D0%B8%D1%86%D0%B5_%D0%B7%D0%B0_%D0%B7%D0%B0%D1%88%D1%82%D0%B8%D1%82%D1%83_%D0%B8_%D1%83%D0%BD%D0%B0%D0%BF%D1%80%D0%B5%D1%92.pdf

Vakkala, H., Sinervo, L.-M., & Jäntti, A. (2021). Local Self-Government in Finland. In B. Brezovnik, I. Hoffman, & J. Kostrubiec (Eds.), Local self-government in Europe (pp. 173-206). Maribor: Institute for Local Self-Government Maribor. doi:10.4335/978-961-7124-00-2.06

World Health Organisation. (2022). Mental health atlas 2020 country profile: Serbia. Retrieved from https://cdn.who.int/media/docs/default-source/mental-health/mental-health-atlas-2020-country-profiles/srb.pdf?sfvrsn=de29305e_4&download=true

World Health Organisation. (n.d.-a). Health expenditure profile by country [Data sets]. Retrieved from https://apps.who.int/nha/database/country_profile/Index/en

World Health Organisation. (n.d.-b). European health information gateway: Indicators explorer [Data sets]. Retrieved from https://gateway.euro.who.int/en/hfa-explorer/

World Health Organization. Regional Office for Europe., Netherlands Institute for Health Services Research., & Institute of Public Health of Serbia “Dr Milan Jovanović Batut”. (‎2010)‎. Evaluation of the organization and provision of primary care in Serbia: A survey-based project in the regions of Vojvodina, Central Serbia and Belgrade. Retrieved from https://iris.who.int/bitstream/handle/10665/368371/WHO-EURO-2010-7621-47388-69613-eng.pdf?sequence=1&isAllowed=y

Zakon o zdravstvenoj zaštiti [Law on Health Care]. (n.d.). Retrieved from https://www.paragraf.rs/propisi_download/zakon_o_zdravstvenoj_zastiti.pdf

Published

2025-01-31

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