Health reform in central and eastern Europe and the former Sovient Union

Rechel, B; McKee, M; (2009) Health reform in central and eastern Europe and the former Sovient Union. Lancet, 374. pp. 1186-1195. ISSN 0140-6736 DOI:

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In the two decades since the fall of the Berlin Wall, former communist countries in Europe have pursued wide-ranging changes to their health systems. We describe three key aspects of these changes-an almost universal switch to health insurance systems, a growing reliance on out-of-pocket payments (both formal and informal), and efforts to strengthen primary health care, often with a model of family medicine delivered by general practitioners. Many decisions about health policy, such as the introduction of health insurance systems or general practice, took into account political issues more than they did evidence. Evidence for whether health reforms have achieved their intended results is sparse. Of crucial importance is that lessons are learnt from experiences of countries to enable development of health systems that meet present and future health needs of populations.

Item Type: Article
Keywords: Aged, Communism, Europe, Eastern, epidemiology, Family Practice, organization & administration, Female, Financing, Personal, trends, Forecasting, Health Care Reform, organization & administration, Health Expenditures, trends, Health Services Research, Health Transition, Humans, Infant Mortality, trends, Infant, Newborn, Life Expectancy, Male, Models, Organizational, National Health Programs, organization & administration, Organizational Innovation, Politics, Primary Health Care, organization & administration, USSR
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
Research Centre: ECOHOST - The Centre for Health and Social Change
Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 19801097
Web of Science ID: 270688200035


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