Davor Mance – University of Rijeka, Faculty of Economics, Ivana Filipovića 4, Rijeka, Croatia
Nenad Vretenar – University of Rijeka, Faculty of Economics, Ivana Filipovića 4, Rijeka, Croatia
Jelena Gojković – University of Rijeka, Faculty of Economics, Ivana Filipovića 4, Rijeka, Croatia


DOI: https://doi.org/10.31410/ITEMA.S.P.2019.65


3rd International Scientific Conference on Recent Advances in Information Technology, Tourism, Economics, Management and Agriculture – ITEMA 2019 – Bratislava, Slovakia, October 24, 2019, SELECTED PAPERS published by the Association of Economists and Managers of the Balkans, Belgrade; Printed by: SKRIPTA International, Belgrade, ISBN 978-86-80194-24-0, ISSN 2683-5991, DOI: https://doi.org/10.31410/ITEMA.S.P.2019




This paper deals with public health systems of European Union Member States. We try to
analyse and compare the public health budget allocation systems in existence in the EU. We analyse
their differences and try to explain where the differences come from. We concentrate on the impact
of differences in economic estimates in decision making on the allocation of scarce funds. We try to
answer the question whether countries with lower income per capita compensate the lack of funds,
lower capital endowment, and the impossibility to invest in equipment with larger labour endowment
or improvement in human capital. On contraire, we find that some of the former transition countries
experience a strong brain drain of medical personnel. Thus, former transition countries with relative
stronger health personnel endowments tend to lose their qualified labour force to the more capital-endowed
developed nations confirming the brain-drain hypothesis and refuting the hypothesis that labour
is a relatively immobile production factor.



Public Health, Health Management Systems, Health Economics, Brain Drain.


Arrow, KJ (1963), Uncertainty and the welfare economics of medical care. American economic
review, 53(5), 941-973. https://web.stanford.edu/~jay/health_class/Readings/Lecture01/
Baumol, W. (1982). Contestable Markets: An Uprising in the Theory of Industry Structure.
American Economic Review, 72(1), 1-15. https://www.jstor.org/stable/1808571
Boncea, I. J. (2014) Brain Drain in Romania: Factors Influencing Physicians’ Emigration. Journal
of Community Positive Practices. Issue No. 1/XIV, pp. 064-074.
Delamaire, ML, Lafortune, G (2010), Nurses in Advanced Roles: A Description and Evaluation
of Experiences in 12 Developed Countries, OECD Health Working Paper, No. 54, OECD
Publishing, Paris. doi: http://dx.doi.org/10.1787/5kmbrcfms5g7-en
Devaux, M, de Looper, M (2012), Income-related Inequalities in Health Service Utilisation
in 19 OECD Countries, OECD Health Working Papers, No. 58, OECD, Paris. doi: http://
Drummond, MF, Sculpher, MJ, Claxton, K, Stoddart, GL, Torrance, GW (2015), Methods for
the Economic Evaluation of Health Care Programmes, 4th edition, Oxford University
Press, Oxford.
Ifanti, A. A.; Argyriou, A. A.; Kalofonou, F. H.; Kalofonos, H. P. (2014) Physicians’ brain drain in
Greece: A perspective on the reasons why and how to address it. Health Policy, 117(2), pp. 210-215.
doi: https://doi.org/10.1016/j.healthpol.2014.03.014
Mance D, Vretenar N, Katunar J (2015) Opportunity cost classification of goods and markets. International
Public Administration Review, Vol. 13(1):119–134. doi: 10.17573/ipar.2015.1.06
Mance D, Mance D, Vitezić D (2016) Incremental cost-effectiveness pharmacoeconomic assessment
of hepatitis C virus therapy: an approach for less wealthy members of the common
market. Croat Med J 57(6):582–590.
Mance D., Mance D., Vitezić D. (2019) Personalized Medicine and Personalized Pricing: Degrees
of Price Discrimination. In: Bodiroga-Vukobrat N., Rukavina D., Pavelić K., Sander
G. (eds) Personalized Medicine in Healthcare Systems. Europeanization and Globalization,
vol 5. Springer, Cham. doi: https://doi.org/10.1007/978-3-030-16465-2_14.
Ottewill, R (1996), Health Care Systems in Liberal Democracies, London and New York: Routledge.
Paun, C. (2016) Skyhigh drug prices made Romania mull unusual path. Politico, Europe edition.
Santerre, RE, Neun, SP (2007), Health economics, theories, insights, and industry studies, 4th
edition, Steve Momper, Thomson, South-Western.


Download Full Paper

Association of Economists and Managers of the Balkans – UdEkoM Balkan
179 Ustanicka St, 11000 Belgrade, Republic of Serbia