Georgia: Health System Review

Area of Science:

• Health Policy
• Health System Analysis
• Public Health

Background:

• Georgia's health system reforms since 2012 aim for universal health coverage.
• Reforms focus on improving access, financial protection, and reducing health inequalities.
• Previous system had limited coverage (45% eligible for state benefits).

Purpose of the Study:

• To analyze the Georgian health system's organization, financing, and performance.
• To review the impact of reforms on universal health coverage.
• To identify challenges and future directions for the health system.

Main Methods:

• Review of developments in health system organization and governance.
• Analysis of health financing, including public spending and out-of-pocket payments.
• Assessment of healthcare provision, reforms, and system performance.

Main Results:

• Over 90% of the population gained entitlement to state-funded benefits by 2013.
• Out-of-pocket payments decreased but remain high (57% of CHE in 2015), dominated by pharmaceuticals.
• Expanded benefits for vulnerable households to cover essential medicines for chronic conditions in 2017.
• System has extensive infrastructure and many doctors but a shortage of nurses.
• Incentives favor emergency/inpatient care over primary care; limited quality improvement incentives.

Conclusions:

• Significant progress made towards universal health coverage in Georgia.
• Continued focus needed on strengthening primary care, public health, and financial protection.
• Addressing workforce shortages (nurses) and provider incentives is crucial for quality improvement.