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First scientific article on Pay for Performance in Macedonia published: Politicization in the healthcare system is documented

There is no clear successful model in the design of P4P schemes;

Many risks exist in development of these reforms;

Attitudes of over 85% of the medical doctors in Macedonia is that politics and political parties interest play major role in the health care system;


(Skopje, December 9, 2012) The expert team of international research project Healthgrouper published first in a series of scientific publications on Pay for Performance in Macedonia. The article titled “Medical doctors’ attitudes towards Pay-for-Reporting in Macedonia: A web-based cross-sectional survey” is published in Macedonian Journal of Medical Sciences. This article is based on the results of the survey conducted via Healthgrouper among medical doctors employed in public and private health care sector in Macedonia.

The article summarizes international experiences related to implementation of P4P projects. Current evidence shows that there is no simple and easy to find successful model of P4P. The difficulties and risks in the design of these reforms are numerous. Experience also shows that success of these reforms mainly depends of inclusion of doctors in the process of planning and implementing the reform. The scientific article for the first time documents the politicization in the health care system. Attitudes of over 85% of the medical doctors who have participated in the survey is that politics and political parties interests have crucial role in the Macedonian health care sector (Figure 1).

Authors Lazarevik & Kasapinov conclude the articled with four key recommendations to the health policy makers in Macedonia:

- The Ministry of health should commission publishing of independent report that will summarize the current experience in implementation of the project and would provide recommendations for next steps;

- The development of the reforms needs to involve doctors over the whole process in the design of the project;

- The P4P project must be first tested in several pilot hospitals before is implemented in practice;

- Finally, it is essential to define monitoring and evaluation parameters over which the effects of the reforms will be assessed, something that does not exist in the current model.

This is the first time in the Republic of Macedonia to use scientific approach in the analysis and evaluation of the effects of implemented health policy where primary target group are the medical doctors who are primary recipients of the reform.

Healthgrouper is an international research project that provides integrated information about health providers in South-East Europe to the patients. Healthgrouper conducts health system research in all countries where the project is active, in order to make comparative analyses for the conditions in the health systems in the region and promote the quality of health care. Final results of the surveys are published online and available in local languages and communicated with the media. For more information, please visit www.healthgrouper.com.

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