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Financial sustainability strategies of public primary health care centres in the Republic of Srpska, Bosnia and Herzegovina
Author(s) -
Rakic Severin,
Djudurovic Aljosa,
Antonic Darijana
Publication year - 2021
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/hpm.3262
Subject(s) - arrears , sustainability , business , context (archaeology) , health care , finance , public health , qualitative research , exploratory research , public relations , economic growth , nursing , medicine , economics , sociology , political science , debt , ecology , paleontology , social science , anthropology , biology
Background The literature on the functioning of public health facilities in health systems with significant arrears is limited. The growing liabilities of health facilities and the accumulating arrears have been a challenge in the Republic of Srpska. Most public primary healthcare (PHC) centres generated a gross loss in 2018. Method Guided by the ‘positive deviance’ approach, we used an exploratory case study design to identify strategies used by managers to achieve financial sustainability in eight top‐performing PHC centres. Qualitative data were collected through face‐to‐face in‐depth semistructured interviews with key informants from the PHC centres that reported positive financial results in 2018. Results Seven organisational goals, comprising 34 financial sustainability strategies, were recognised during the data analysis and were used to build an organisational‐level model for a PHC centre. Conclusion Managers concurrently used multiple strategies to ensure financial sustainability. Each centre tailored its range of strategies to the organisational context, local context, and wider environment of the health system. The strategies were conceived and implemented by managers operating at different organisational levels under the leadership of top‐level managers. Managers of indebted health facilities can learn from the positively deviant peers who manage facilities that achieved satisfactory financial performance.