Health reform in central and eastern Europe and the former Soviet Union.

Full Abstract

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.

Author information

Author/s: Rechel, Bernd (B); McKee, Martin (M);

Affiliation: European Observatory on Health Systems and Policies, London, UK. bernd.rechel(-atsign-)lshtm.ac.uk

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Review

Journal: Lancet (Lancet), published in England. (Language: eng)

Reference: 2009-Oct; vol 374 (issue 9696) : pp 1186-95

Dates: Created 2009/10/05; Completed 2009/10/15;

PMID: 19801097, status: MEDLINE (last retrieval date: 10/15/2009, IMS Date: )

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