Predictors of self-medication in Serbian adult population: cross-sectional study.

Background In spite of many benefits for individuals and community, self-medication has a number of potential risks. Objective To identify predictors of self-medication with over-the-counter and prescription (Rx) medicines without doctor's prescription. Setting Serbian population of 15 years of age and over. Method This was crosssectional, epidemiological study. Data have been drawn from Serbian National Health Survey 2013 database. Predictors of self-medication were determined among sociodemographic, health related and health services related factors, using multivariate logistic regression models. Main outcome measure Prevalence and predictors of selfmedication. Results The study included 14,623 participants. The prevalence of selfmedication was 27.1 and 24% after exclusion of vitamins, minerals and herbal preparations. Medicines for pain relief were the mostly used medicines without doctors' prescription in 18.4% of participants. A relatively high prevalence of self-medication with Rx medicines, (1) tranquilizers and sleeping pills, (2) antibiotics and (3) antihypertensives, was found, 4, 2.5 and 1.9%, respectively. Socio-demographic factors (middle age, female gender, higher level of education), health related factors (chronic disease, stress, physical pain), and health service related factors (nonrealized healthcare needs due to long waiting, dissatisfaction with publicly funded health services) have been found as significantly associated with self-medication. Conclusion Self-medication in Serbia is predicted by socio-demographic and health related factors, unmet needs for healthcare and dissatisfaction with publicly funded healthcare services. Improvements in healthcare system, particularly, shortening of long waiting for healthcare services and improvements in pharmaceutical services, particularly better control of Rx medicines dispensing, could contribute in improvement of responsible self-medication.

[Assessment of health care quality in the tertiary level pediatric hospitals in Serbia].

BACKGROUND/AIM: It is necessary to improve the quality of health care for children. Assessment data would provide new insights into better treatment outcomes. The aim of this descriptive study was to estimate and to compare applied quality indicators in five pediatric in-patient tertiary level institutions in Serbia during the period from January 1st to December 31st 2008. METHODS: Quality data and indicators were collected in the Institute for Public Health of Serbia "Dr. Milan Jovanovid Batut". Descriptive statistics and chi-square test were used for data analysis. RESULTS: The average length of stay (ALOS) in pediatric departments was 7.51 + 1.30 days (5.88-8.91 days). In the same period, ALOS in pediatric surgery departments was 5.85 +/- 1.50 days (3.58-7.57 days). The average number of nurses per occupied bed was 0.76 +/- 0.20 and 1.09 +/- 0.36 in pediatric and in pediatric surgery departments, respectively. The number of operated patients per surgeon was in the range 51.0-160.5. The annual case fatality rate in pediatric departments was estimated to 0.72% +/- 0.20%, whereas in pediatric surgery departments it was 0.34% +/- 0.25%. The autopsy rate was estimated to 0.00%-63.16% in pediatric departments, and 37.14%-80.00% in pediatric surgery departments. There was statistically significant difference among the five hospitals regarding the following indicators of quality of work: total annual mortality rate of patients, autopsy rate, number of rate of patients, autopsy rate, number of patients referred to other institutions, both in pediatric and pediatric surgery departments. CONCLUSION: There is a significant difference among the five hospitals regarding indicators of quality of work. Obligatory set of quality indicators on the basis of legislative acts are the indicators of general quality of work in hospital. It is necessary to establish specific pediatric quality indicators and to define national standards related to these indicators.