Financing healthcare in central and Eastern European Countries : how far are we from Universal Health Coverage?

After the fall of communism, the healthcare systems of Central and Eastern European countries underwent enormous transformation, resulting in departure from publicly financed healthcare. This had significant adverse effects on equity in healthcare, which are still evident. In this paper, we analyzed the role of government and households in financing healthcare in eight countries (EU-8): Czechia, Estonia, Hungary, Latvia, Lithuania, Poland, Slovakia, and Slovenia. A desk research method was applied to collect quantitative data on healthcare expenditures and qualitative data on gaps in universal health coverage. A linear regression analysis was used to analyze a trend in health expenditure over the years 2000-2018. Our results indicate that a high reliance on out-of-pocket payments persists in many EU-8 countries, and only a few countries have shown a significant downward trend over time. The gaps in universal coverage in the EU-8 countries are due to explicit rationing (a limited benefit package, patient cost sharing) and implicit mechanisms (wait times). There is need to increase the role of public financing in CEE countries through budget prioritization, reducing patient co-payments for medical products and medicines, and extending the benefit package for these goods, as well as improving the quality of care

The future of long-term care in ten European countries : review of policy reports and qualitative study among country experts

The provision of good quality long-term care to citizens represents a challenge for many European countries due to tight public budgets and ongoing societal transitions. To gain insights on the future of long-term care in Europe, an explorative study was conducted consisting of a review of policy reports and qualitative study among country experts from Albania, Bulgaria, France, Germany, Lithuania, the Netherlands, Poland, Portugal, Ukraine, and the United Kingdom. For the purpose of the analysis, a conceptual framework was developed. Based on this framework, the method of qualitative directed content analysis was applied to extract and analyze information from the reports and study transcripts. The results suggest four key directions for long-term care development: (a) integration, coordination and cooperation across structures and actors for better service quality; (b) increased scope and scale of formal service provision; (c) improved workforce planning and capacity building; (d) use of e-health andinformation technologies. The exact direction is however dependent on the country-specific guiding principles, governance capacity and funding constraints. To adequately respond to current challenges, policy-makers need to acknowledge the interconnectedness of long-term care issues and approach them from a more holistic perspective

Źródła finansowania opieki zdrowotnej

The sources of health care funding The question how to mobilize financial resources for health care is one of the most frequently asked questions in health care debates. It is also relevant in Poland, where although various health care reforms in the last two decades, there is still no consensus on how health care should be funded. The ambiguous nature of health care services indicates that both public and private methods of funding should be applied in order to obtain the best value for money. In practice both private and public sources are used. However wealthier European countries, rely strongly on public solidarity-based funding. Whereas in the framework of public sources there is a never ending debate what is more effective: general taxation or insurance contribution. Debate on private sources is still on the agenda as well, particularly in post socialistic countries. Private insurance or co-payment and what kind in both cases are the main question. In this paper, we present a review of public and private methods of health care funding focusing on their main characteristics, their application in European countries, and their effects. TQhe analysis relies on secondary data, i.e. a review of the literature and health expenditure databases.

Long-term care provision in Europe : results of a desk research study

This paper describes the provision of long-term care across Europe based on data gathered in a desk research. The aim is: (1) to identify indicators of long-term care provision; and (2) to compare the provision of formal and informal care across the European countries. For this purpose, a narrative literature review was carried out to identify relevant indicators. Subsequently, a descriptive analysis was performed to analyse the indicator related data. The results suggested that there are important differences in the long-term care provision in Europe. Long-term care is provided both at public and private institutions. The entitlement criteria vary among countries. In general, Western and Northern European countries have more generous provision of residential care compared to Eastern and Southern European countries. At the same time, informal care has different roles and it is extremely important in Eastern and Southern European countries. Among all countries, more than half have quality assurance regulations forresidential care. However, most of the Southern and Eastern European countries lack information about the quality assurance regulations. In order to monitor the long-term care provision, it is recommended that European countries establish a reporting system to provide annual data. These annual data should be based on identical measurement mechanisms and standardised reporting structure to allow for comparison and improvements of long-term care systems

Raport dla WHO o zadłużeniu szpitali

W dniach 30 czerwca–11 lipca 2008 roku odbyła się III Międzynarodowa Konferencja pt. „European Summer University on Medical Law” zorganizowana przez Polskie Towarzystwo Prawa Medycznego przy współpracy Francuskiego Stowarzyszenia Badań i Edukacji w dziedzinie Prawa Medycznego, Wydziału Nauk o Zdrowiu, Uniwersytet Jagielloński Collegium Medicum oraz Uniwersytetu im. Paula Sabatiera w Tuluzie. Inicjatywa organizacji międzynarodowych letnich konferencji prawa medycznego podjęta była w roku 2005 w toku IX seminarium prawa medycznego, które odbyło się w Tuluzie we Francji. Rok później w dniach 3–11 sierpnia został zorganizowany pierwszy Europejski Uniwersytet Letni w Tuluzie, przy udziale kilkunastu uniwersytetów europejskich (z Francji, Belgii, Hiszpanii, Włoch, Polski – UJ), a także z Kanady oraz Algierii i Tunezji. W toku jego obrad Komitet Pedagogiczny składający się z przedstawicieli wymienionych uczelni podjął decyzję, że w następnych latach 2-tygodniowe konferencje będą się odbywać każdego roku w dwóch krajach. W rezultacie tego w roku 2007 pierwszy tydzień II Europejskiego Uniwersytetu Letniego odbył się na Uniwersytecie w Tuluzie, drugi zaś na Uniwersytecie w Madrycie. W roku 2008 tradycyjnie pierwszy tydzień konferencji zorganizował także Uniwersytet w Tuluzie (30 czerwca–2 lipca), drugi zaś Instytut Zdrowia Publicznego Wydziału Nauk o Zdrowiu UJ CM (7–11 lipca)

Wprowadzenie dopłat pacjentów do świadczeń opieki zdrowotnej finansowanych ze środków publicznych – opinie głównych uczestników polskiego systemu opieki zdrowotnej

Introduction of patient payments for publicly financed health care services – opinions of the main Polish health care system’s stakeholdersDuring the last decades many European governments have introduced patient payments in their public health care system with the aim to improve efficiency of health care provision, contain overall health care expenditure, and also to generate additional resources. In Poland, since 1999 patients have met formal payment obligations when they use dental services. Though introduction of formal patient payments for primary care services, out-patient specialists’ services and hospital services has been discussed, such payments do not exist. Empirical evidence suggests that the successful implementation of patient payments, to a large extent, depends upon public acceptance and political consensus. The paper presents the results of study on attitudes towards formal patient payments for publicly financed health care services, among different groups of Polish health care system’s stakeholders (health care consumers, providers, insurers and policy makers). The data are collected via focus group discussions and in-depth interviews carried out in Poland in June–October 2009 as part of project ASSPRO CEE 2007. The results are used to out-line policy recommendations

Long-term care financing in Europe : an overview

Despite the growing interest in the sustainability of long-term care (LTC) systems, only a few studies have investigated the differences in the LTC financing across European countries. The objective of this paper is to describe the financing of LTC in Europe. For this purpose, we use indicators on LTC financing taken from international databases and reports. Desk research was carried out to identify relevant indicators. Hierarchical cluster analysis was used to identify typologies in LTC financing across the EU/EEA countries based on seven indicators selected. We found large differences in LTC financing across the EU/EEA countries in terms of total expenditure, the division of expenditure between the social and health care system, and in the role of in-kind and cash benefits. Four main financial models across the EU/EEA countries could be distinguished. Further, we identified some shortages in data reporting on the financing of LTC services. Some limitations and contradictions related to the indicators of LTC financing are highlighted. In particular, we stress the need for more comprehensive data to enable further cross-country comparisons and to provide valid input for policy