Vol. 14 No. 2 (2022): Arch Pub Health
Public Health

Organization of health care of elderly people in the city of Skopje - conditions and needs

Nadica Totikj
Institute of Public Health of the Republic of North Macedonia, Skopje, Republic of North Macedonia
Elena Kjosevska
Institute of Public Health of the Republic of North Macedonia, Skopje, Republic of North Macedonia
Vesna Velikj Stefanovska
Institute of Epidemiology with Biostatistics and Medical Informatics, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

Published 2022-12-30


  • elderly,
  • health care,
  • active and healthy aging

How to Cite

Totikj N, Kjosevska E, Velikj Stefanovska V. Organization of health care of elderly people in the city of Skopje - conditions and needs. Arch Pub Health [Internet]. 2022 Dec. 30 [cited 2023 Jan. 27];14(2):46-57. Available from: https://id-press.eu/aph/article/view/6070


The main goal of the paper was to understand the attitudes of the elderly in the city of Skopje regarding health care, organization and functioning of the health system for ensuring healthy and active aging. Methods: A descriptive-analytical method was used to present the results of the study (cross-sectional study) conducted on the territory of the city of Skopje in the period March-April 2019. A total of 350 respondents aged 65+ were included. A questionnaire containing 53 questions was developed and was designed to suit the age and sex of the respondents. The questionnaire was divided into four parts: first part - general and demographic characteristics; second part - health care; third part - mobility of the elderly; fourth part - conditions and lifestyle. The statistical analysis was performed with Windows 7.0 and SPSS, version 14. A statistical significance was used for two-way tests with a significance level of p <0.05. Results: Of the total of 350 respondents, 133 (38%) were male, and 217 (62%) were female, with a sex ratio of 0.61 : 1. According to the answers given by the respondents in our sample, 50 (37.9%) men and 124 (57.14%) women had chronic diseases. A total of 260 (75.6%) respondents stated that they were satisfied with the health information system "My Appointment" (“Moj Termin”). In terms of sex, 101 (78.9%) men and 159 (73.6%) women were satisfied with "My Appointment". A total of 84 (24.4%), 27 (21.1%) men and 57 (26.4%) women, stated that they were dissatisfied with this service. Forty-seven (47.5%) respondents said that discrimination in health care was done by a doctor, 43 (43.4%) said it was done by a nurse and  according to 9 (9.1%) respondents, discrimination was done by both the doctor and the nurse. The results obtained showed that more often highly educated people recognized discrimination and abuse by the health personnel than people with lower level of education. Conclusion: The elderly exercise partially their rights to social and health care. The elderly would like to expand the opportunities for social and health benefits. In the self-assessment of the health condition, most of the elderly perceived their health status to be relatively good. The analysis showed a higher percentage of chronic illnesses in women than in men. Тhere is a correlation between active and healthy aging and socioeconomic conditions in which the elderly live.


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  1. Word Health Organization. Ageing and health- Key facts. 2021 Accessed: 18.03.2022.
  2. Galic S, Tomasovic Mrcela N et al. Practitioner for gerontology, geriatrics and psychology of old age- psychology of aging. Medical School Osijek, 2013
  3. World Health Organization. Age-friendly environments in Europe: Indicators, monitoring and assessments. Available at:http://www.euro.who.int/en/health-topics/Life-stages/healthy-ageing/publications/2018/age-friendly-environments-in-europe-indicators,-monitoring-and-assessments-2018.Accessed: November 30, 2019
  4. Eurostat Statistics Explained. Population structure and ageing. Available at:https://ec.europa.eu/eurostat/statisticsexplained/index.php?title=Population_structure_and_ageing.Accessed: March 19,2022
  5. State Statistical Office. North Macedonia in numbers. 2021.Аvailableat:https://www.stat.gov.mk/PrikaziPublikacija_1.aspx?rbr=833.Accessed: 25.02.2022.
  6. State Statistical Office. Deaths by age, by municipality, 2005-2020 Available at:
  7. http://makstat.stat.gov.mk/PXWeb/pxweb/mk/MakStat/MakStat__Naselenie__Vitalna/225_VitStat_Op_UmrVoz_mk.px/?rxid=a92d871e-9d22-40c1-bfb2-de922334917d. Accessed: February 25, 2022
  8. Data World Bank. Live expectancy at birth. Total (years)-North Macedonia. Available at:data.worldbank.org/indicator/SP.DYN.LE00.IN?locations=MKAccessed: March 10,2022
  9. World Atlas. Countries with the largest aging population in the world. Available at:https://www.worldatlas.com/articles/countries-with-the-largest-aging-population-in-the-world.html. Accessed: 19.05.2019
  10. ActiveAgeingIndex2014 Summary. Available at:https://statswiki.unece.org/display/AAI/VI.+Documents+and+publications?preview=/76287849/117178632/extract_for_translation3%20updated--.pdf. Accessed: June, 2015
  11. National institute of ageing. Global ageing, Available at: https://www.nia.nih.gov/research/dbsr/global-aging. Accessed: November 21,2019
  12. Vlahovic V, et al. Guide to implementing the National Strategy for Equality and Non-Discrimination on the basis of ethnicity, age, mental and physical disability, and on a sex basis. Skopje: British Council in Macedonia, 2014, pp.33-34.
  13. Ylli, A. Health and social conditions of older people in Albania: Baseline data from a national survey. Public Health Rev 2010; 3:, 549–560.
  14. Jerliu N, Toçi E, Burazer, G. et al. Socioeconomic conditions of elderly people in Kosovo: a cross-sectional study. BMC Public Health 2012;12: 512.
  15. Frontiers in Public Health. Predicting Self-Rated Health in Diabetes and Chronic Heart Failure – A Multiple Mediation Model Front. Available at: https://www.frontiersin.org/articles/10.3389/fpubh.2015.00266/fullPublic Health Accessed: 21.02.2022
  16. World Health Organization. Regional Office for Europe (WHO). European report on preventing elder maltreatment.Copenhagen;2011. Available at: https://www.euro.who.int/__data/assets/pdf_file/0010/144676/e95110.pdf
  17. World Health Organization. Older people and access to health care in North Macedonia. 2021. Available at:https://www.euro.who.int/en/countries/north-macedonia/publications/older-people-and-access-to-health-care-in-north-macedonia-2021 Accessed:15 March,2022.
  18. Rippon I, KnealeD, Demakakos P, Steptoe A. Perceived age discrimination in older adults. Age and Ageing 2014; 43(3):379-386
  19. Jordanova Peshevska D, Markovik M, Sethi D, Serafimovska E, Jordanova T. Prevalence of Elder Abuse and Neglect: Findings from First Macedonian Study. OA Maced J Med Sci 2014; 2(2):353-359.
  20. Liotta G, Canhao H, Cenko F, Cutini R, Vellone E, Illario M, et al. Active ageing in Europe: Adding healthy life to years. Front Med 2018; 5:123.
  21. Kjosevska E, Totikj N. Report for health status and health care of elderly people. Institute of Public Health of Republic of Macedonia. Skopje, 2021.