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Reforma de la salud en Europa central y oriental y la antigua Unión Soviética
1European Observatory on Health Systems and Policies, London, UK. bernd.rechel@lshtm.ac.uk
Lancet (London, England)
|October 6, 2009
Resumen
Los antiguos países comunistas de Europa reformaron sus sistemas de salud después del Muro de Berlín, adoptando modelos de seguro de salud y atención primaria. La evidencia sobre la efectividad de las reformas sigue siendo limitada, lo que pone de relieve la necesidad de aprender de las experiencias.
Área de la Ciencia:
- Salud Pública La salud pública.
- Política de salud Política de salud
- Sistemas de Salud Investigación de Sistemas de Salud
Sus antecedentes:
- Las naciones europeas poscomunistas experimentaron importantes transformaciones en el sistema de salud durante dos décadas.
- Los cambios clave incluyen la adopción de un seguro de salud universal, el aumento de los pagos de bolsillo y el fortalecimiento de la atención primaria.
Objetivo del estudio:
- Para describir los principales cambios en el sistema de salud en los antiguos países europeos comunistas.
- Analizar los impulsores y la base de evidencia para estas reformas de salud.
Principales métodos:
- Análisis descriptivo de los cambios en el sistema de salud.
- Revisión de las decisiones políticas y la evidencia disponible sobre los resultados de las reformas.
Principales resultados:
- La adopción generalizada de los sistemas de seguro de salud.
- Aumento de la dependencia de los pagos formales e informales de su propio bolsillo.
- Cambiar hacia modelos de medicina familiar con médicos generales.
Conclusiones:
- Las decisiones de política de salud a menudo estaban impulsadas políticamente en lugar de basarse en la evidencia.
- Existen escasas pruebas sobre el éxito de las reformas de salud implementadas.
- Aprender de las experiencias de los países es crucial para el futuro desarrollo del sistema de salud.
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