Towards The Efficient Use Of Public Healthcare Resources In Croatia

Rational and efficient use of pubic resources is crucial in order to reduce the healthcare costs and consequently to decrease the problem of excessive indebtedness of public healthcare providers in Croatia. Given the growing prevalence of chronic disease (e.g. cancer), secondary prevention (screenings of risky population) has the potential for achieving significant savings in the health care system. Nowadays, many national health care systems are focusing on disease preventing activities. Pap test is proven to be the most cost-effective method of early detection of cervical cancer. Unfortunately, with the model of opportunistic screening a large percentage of women rarely undergo the Pap test, which points to a need for an organized screening program. One of the goals of such programs is to detect a larger population of women with pathological cell changes. The purpose of this paper is to analyze the justification for the implementation of organized screening for cervical cancer by examining the relationship between the number of Pap tests and number of pathological Pap test results as a share in abnormal Pap test results. The estimation is carried out within vector autoregressive (VAR) model and Granger causality testing. Standard Granger causality analysis was helpful in establishing the direction of causal links between the variables of interest, while the signs of these relationships are examined by using impulse response function. Findings suggest that there is a unidirectional causality that runs from number of conducted Pap smears to the share of pathological in abnormal Pap results. Also, results indicate that Pap smears cause a positive response in the share of pathological in abnormal Pap results. This indicates that as the number of conducted Pap smears increases (which can only be done as part of organized screening programs) there will be more cases of an early detection of disease, which could result in healthier population and decrease in health care costs, resulting in less insolvency problems for individuals as well as for the public health care.