Croatian primary healthcare system attracts many young physicians, who can be an important part of disaster and emergency management. However, the lack of experience despite a high motivation indicates a need for inclusion of disaster medicine training during undergraduate studies and annual educational activities.

Background: Metamizole is a medication with analgesic, antipyretic, spasmolytic, and weak anti-inflammatory effects. The aim of our study was to evaluate a six-year trend in the utilization and expenditure of metamizole in comparison to other group of licensed non-opioid analgesics in Serbia and Croatia, in order to rationalize its use and prescribing in these countries.Methods: The data of metamizole vs. all other non-opioid analgesics utilization and expenditure in Serbia and Croatia was analyzed according to the WHO methodology and expressed as defined daily doses per 1,000 inhabitants per day (DDD/1,000 inhabitants/per day) and total costs, respectively, during the 6-year period from 2010 to 2015.Results: In the observed period, utilization of metamizole was 3.31 fold higher in Serbia than in Croatia (median in Serbia was 2.238 vs. 0.675 in Croatia DDD/1,000 inhabitants/per day/per year). Expenditure of metamizole in the same period was 5.29-fold higher in Serbia than in Croatia (median in Serbia was 1,738,192.51 €/per year vs. 328,355.03 €/per year in Croatia).Conclusion: Utilization and expenditure of non-opioid analgesics, including metamizole, in Serbia was significantly higher comparing with Croatia.Further research is needed to determine whether the current analgesic consumption in Serbia meets the needs of the patient. The benefits of metamizole should be weighed against the risk of metamizole-induced adverse effects. Until then, its prescribing should be based on indications and the appropriate duration of therapy.

Sharing of prescription analgesics is a highly prevalent behaviour amongst pain patients, and there exist independent factors associated with such conduct. This information can be useful in the design of interventions aimed at mitigating analgesic sharing behaviour in the future.

Although many steps forward have been made in the reform and implementation of the family medicine-oriented model of primary health care in Bosnia and Herzegovina, our results revealed that there is still much room for improvement. Particular attention should be paid to establishing common goals and reaching mutual understanding with key stakeholders.

Introduction:The literature indicates different factors influencing recruitment of health professional students to work in rural areas. The purpose of this study is to explore the willingness of health profession students in the Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina to work in a rural area following graduation and the factors influencing incentives to pursue a rural career. Methods:The cross-sectional study included first-year through sixth-year students aged 18 years or older and enrolled in one of three study programs at the Faculty of Medicine: medicine, dentistry and nursing. The questionnaire was distributed at the beginning of the winter semester during the first required lecture for each year and study program class. Data was analyzed using student t-test, analysis of variance when appropriate, Kruskal-Wallis test and multivariate logistic regression analysis. Results: A total of 519 students participated, an 88.3% response rate. Three hundred and ninety-nine (77%) participants responded positively to the question 'When you complete your studies, would you be inclined to accept a job in a rural region?' Factors associated with willingness to practise in rural areas included being female (p=0.027) and having a rural upbringing (p=0.037). Significant differences between medicine, nursing and dentistry students were found in their opinion that willingness to work in rural practice depends greatly on the possibility to get residency more easily (p=0.001). Compared to their peers, nursing students had better opportunities to attend national courses cost-free (p=0.027) and to be involved in the education of new generations of health profession students (p=0.001). Getting a post in an urban area after a work period in a rural area was most valued as an incentive by dentistry students (p=0.037). The multivariate logistic regression model was used to analyze predictors of willingness to practise in rural areas. Students who had been raised in a rural community (p=0.042) as well as female students (p=0.016) were more likely to accept rural practice. Statistical significance at an alpha level of 0.05 was not reached for study program and year of study. Conclusions:The results of the study showed a high willingness of medicine, dentistry and nursing students to work in rural areas following graduation. Female students and students who were raised in a rural community were more likely to choose a rural career. Stakeholders should be committed to strengthening the rural deployment of health professionals by creating a more attractive, rural environment.

Introduction: After family medicine’s famous beginnings in the early 60’s through introduction of the world’s first family medicine specialization, with transitional changes and war also come changes in former Yugoslavia’s healthcare systems. Aim: The primary aim of this article is to analyze frequency and causes of sanctioning of family physicians by Health insurance funds in the countries of former Yugoslavia. The secondary aim is to evaluate frequency and types of workplace violence family physicians experienced due to insurance boundaries for patients. Methods: The comparative, cross-sectional survey was carried out from October 2017 to February 2018. Study participants were general practitioners’ (GPs), family physicians (FPs) and those without a specialty designation but providing family medicine services in one of the five Western Balkans countries: Croatia, Slovenia, Serbia, Macedonia and Bosnia and Herzegovina (B&H). The questionnaire was designed for the purpose of the study. Results: Forty-nine percent of participating physicians have been sanctioned by Health Insurance Fund and 77. 5% has been exposed to workplace violence. The most common type of violence was verbal (76.6%). Financial penalties according to the scale had the highest rates in Macedonia (73.9%) and Slovenia (43.9%). Conclusion: It is necessary to educate creators of healthcare policies, doctors and patients for the purpose of establishing partner relations which would lead to strengthening of primary healthcare, but also to a more efficient healthcare system.

BackgroundDuring the transition processes, the Western Balkan countries were affected by conflicts and transition-related changes. Life expectancy in these countries is lower, while the mortality from non-communicable diseases (NCDs) is higher in comparison with western and northern parts of Europe. The primary aim of this study was to analyze the treatment possibilities for the most common NCDs in the Western Balkan countries. The secondary aim was to understand and compare the policies regarding prescribing-related competencies of family physicians.MethodsIn June and July 2017, a document analysis was performed of national positive medicines lists, strategic documents, and clinical guidelines for the treatment of the most frequent NCDs; arterial hypertension, diabetes, hyperlipidemia, asthma, and chronic obstructive pulmonary disease (COPD). All text phrases that referred to medicines prescribing were extracted and sorted into following domains: medicine availability, prescribing policy, and medication prescribing-related competencies.ResultsPossibilities for treatment of arterial hypertension, diabetes, hyperlipidemia, asthma, and COPD vary across the Western Balkan countries. This variance is reflected in the number of registered medicines, number of parallels, and number of different combinations, as well as restrictions placed on family physicians in prescribing insulin, inhaled corticosteroids, statins and angiotensin II receptor blockers (ARBs), without consultant’s recommendation.ConclusionWestern Balkan countries are capable of providing essential medicines for the treatment of NCDs, with full or partial reimbursement. There are some exceptions, related to statins, newer generation of oral antidiabetic agents and some of the antihypertensive combinations. Prescribing-related competences of family physicians are limited. However, this practice is not compliant to the practices of family medicine, its principles and primary care structures, and may potentially result in increased health-care financial ramifications to both the system and patients due to frequent referrals to the specialists.

Organization of international medical congresses is a perfect example of multidisciplinary cooperation with professional medical associations and Medical schools on one side and professional congress organizers on the other. Medical congresses are perhaps most frequent congresses in the world. Organization of medical congresses can be achieved in a number of ways: Organizers can be local professional associations or Medical schools, international professional associations and international professional congress organizers. To be nominated for organization of a congress, successful cooperation of medical professionals is needed, especially doctors and professional congress organizers. Success largely depends on knowledge of the availability of conference halls, available accommodations in the vicinity of the congress halls, ease of access to the congress destination, expectancies of possible candidates who will attend in connection to the congress destination, lobbying for nomination for organization of a congress. This article will analyze availability of conference halls in Croatia, accommodation capacities, transport possibilities. For the needs of this article, pilot questionnaire was constructed about demands of possible participants and their preferable destinations to be visited. Statistical analysis of Medical congresses in Europe is also shown according to geographical spreading. Concluding the article, we show that better education of medical staff about the possibilities of professional congress organizing are very important, as well as sharing of the experiences from big congresses among the medical professional in the field of medical congress organization. With multidisciplinary approach of all participants in organization of the congress (Ministry of Tourism, Croatian Tourist Association, Croatian Associations of professionals in congress tourism, hotels, medical professionals) Croatia could be much better recognized as destination for organizing medical congresses.