Tool for assessment of attitudes for applying a new approach in the decision-making process for reimbursement list in Bosnia and Herzegovina

The healthcare structure in Bosnia and Herzegovina is decentralized, thus facing patients with unequal access to healthcare services especially for medicines. We attempted to develop a tool for assessment of the stakeholders' opinion, and with the further research we will propose the model that can bring equality in Bosnia and Herzegovina. The developed tool will examine the attitudes and opinions for introducing new methods in the decision-making process during the listing of medicines for the reimbursement list in Bosnia and Herzegovina. An update of the country's legislation can be presented based on the research results. The tool was developed using the Delphi method. The experts who were included in the Delphi panel are qualified for rating and discussing questions. The questionnaire was validated on a 5-point Likert scale, and additional comments or clarification are optional. Introductory interviews were held face to face with each expert individually; after that the panel was anonymous. After 3 rounds of Delphi, the created tool was checked through a pilot study. The developed tool was categorized into three groups based on the KAP survey (Knowledge, Attitudes, Perceptions). All questions were verified in pilot and with the results for Cronbach's alpha 0.96. This shows sufficient reliability of the created questionnaire, and it can be administered to a larger group of respondents, which has been planned for further research. The findings provide reliable information useful for planning the country's legislation updates and planning for the introduction of a new approach in the decision-making process.