Since the 1990s, diagnosis-related group (DRG)-based payment systems were gradually introduced in many countries. The main design characteristics of a DRG-based payment system are an exhaustive patient case classification system (ie, the system of diagnosis-related groupings) and the payment formula, which is based on the base rate multiplied by a relative cost weight specific for each DRG. Cases within the same DRG code group are expected to undergo similar clinical evolution. Consecutively, they should incur the costs of diagnostics and treatment within a predefined scale. Such predictability was proven in a number of cost-of-illness studies conducted on major prosperity diseases alongside clinical trials on efficiency. This was the case with risky pregnancies, chronic obstructive pulmonary disease, diabetes, depression, alcohol addiction, hepatitis, and cancer. This article presents experience of introduced DRG-based payments in countries of western and eastern Europe, Scandinavia, United States, Canada, and Australia. This article presents the results of few selected reviews and systematic reviews of the following evidence: published reports on health system reforms by World Health Organization, World Bank, Organization for Economic Co-operation and Development, Canadian Institute for Health Information, Canadian Health Services Research Foundation, and Centre for Health Economics University of York. Diverse payment systems have different strengths and weaknesses in relation to the various objectives. The advantages of the DRG payment system are reflected in the increased efficiency and transparency and reduced average length of stay. The disadvantage of DRG is creating financial incentives toward earlier hospital discharges. Occasionally, such polices are not in full accordance with the clinical benefit priorities.

Studies in the alcohol consumption area are mostly related to the (ab)use of alcohol in young people. However, today, a growing number of researchers are emphasizing the clinical and public health significance of alcohol consumption in the elderly. In the WHO reports, harmful alcohol consumption is responsible for 5.3% of the global burden of the disease. The aim of this study was to investigate the prevalence of alcohol consumption among men and women aged 55 and over in Serbia and Hungary, leveraging data from the 2013 Serbian National Health Survey and from the 2014 Hungarian National Health Survey. Respondents aged 55 and over were analysed based on logistic multivariate models. The prevalence of alcohol consumption was 41.5% and 62.5% in Serbia and Hungary, respectively. It was higher among men in both countries, but among women, it was significantly higher in Hungary than in Serbia. The statistically significant predictors affecting alcohol consumption in Serbia included age, education, well-being index, long-term disease and overall health status, with marital status being an additional factor among men. In Hungary, education and long-term disease affected alcohol consumption in both sexes, while age and employment were additional factors among women. In both countries for both sexes, younger age, more significantly than primary education and good health, was associated with a higher likelihood of alcohol consumption.

Satisfaction with Health Services among the Citizens of Serbia

Background: Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients. Methods: This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms. Results: The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26-63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media. Conclusion: Caring for the mental health of cancer patients must occupy a significant part of each country's national health policy.

Background: Comorbidities are major predictors of in-hospital mortality in stroke patients. The Charlson comorbidity index (CCI) and the Elikhauser comorbidity index (ECI) are scoring systems for classifying comorbidities. We aimed to compare the performance of the CCI and ECI to predict in-hospital mortality in stroke patients. Methods: We included patients hospitalized for stroke in the Clinical Center of Kragujevac, Serbia for the last 7 years. Hospitalizations caused by stroke, were identified by the International Classification of Diseases-10 (ICD-10) codes I60.0 - I69.9. All patients were divided into two cohorts: Alive cohort (n=3297) and Mortality cohort (n=978). Results: There were significant associations between higher CCIS and increased risk of in-hospital mortality (HR = 1.07, 95% CI = 1.01–1.12) and between higher ECIS and increased risk of in-hospital mortality (HR = 1.04, 95% CI = 0.99–1.09). Almost 2/3 patients (66.9%) had comorbidities included in the CCI score and 1/3 patients (30.2%) had comorbidities included in the ECI score. The statistically significant higher CCI score (t = -3.88, df = 1017.96, P <0.01) and ECI score (t = -6.7, df = 1447.32, P <0.01) was in the mortality cohort. Area Under the Curve for ECI score was 0.606 and for CCI score was 0.549. Conclusion: Both, the CCI and the ECI can be used as scoring systems for classifying comorbidities in the administrative databases, but the model’s ECI Score had a better discriminative performance of in-hospital mortality in the stroke patients than the CCI Score model.

The inhabitants of the Dinaric Alps (former Yugoslavia and Albania) have long been known as people of impressive body height, but after World War II, there was a critical lack of data related to this phenomenon. This anthropological synthesis includes the measurements of 47,158 individuals (24,642 males and 22,516 females) from the period 2010–2018 and describes detailed regional differences in male stature in the Western Balkans. According to these data, young men from Montenegro (182.9 cm) are currently the tallest 18-year-olds in the world, surpassing their Dutch peers (182.4 cm), and 18-year-old boys from Dalmatia are even taller (183.7 cm) at a regional level. A continuous belt of extraordinary height means (>184 cm) stretches from the Adriatic coast of Dalmatia through Herzegovina to the central part of Montenegro. This article summarizes all the key socio-economic, nutritional, and genetic data, and offers possible explanations for this anthropological phenomenon. Since the remarkable height of the Dinaric populations cannot be connected with any commonly known environmental factor, the most probable hypothesis is genetic and links these physical characteristics with the local founder effect of Y haplogroup I-M170. Furthermore, given that both the level of socio-economic development and dietary protein quality are still sub-optimal, the local upward trend in body height has the potential to continue in the future.