中欧と東欧,旧ソ連における医療改革
1European Observatory on Health Systems and Policies, London, UK. bernd.rechel@lshtm.ac.uk
Lancet (London, England)
|October 6, 2009
まとめ
欧州の旧共産主義国は,ベルリンの壁の後,医療制度を改革し,健康保険と初等医療モデルを採用した. 改革の有効性に関する証拠は依然として限られており,経験から学ぶ必要があることを強調しています.
科学分野:
- 公衆衛生は公衆衛生である.
- 健康政策 保健政策 保健政策
- 医療システム研究 医療システム研究
背景:
- 共産主義後のヨーロッパ諸国は,20年以上にわたり,医療制度に大きな変革を遂げました.
- 重要な変更には,全般医療保険の導入,自費の増額,初等医療の強化が含まれています.
研究 の 目的:
- 元共産主義ヨーロッパ諸国における主要な保健システム変化を記述する.
- これらの健康改革の推進要因と証拠基盤を分析する.
主な方法:
- 医療制度の変化に関する記述的分析.
- 政策決定の見直しと,改革成果に関する利用可能な証拠.
主要な成果:
- 医療保険制度が広く採用される.
- 公式と非公式の自己負担による支払いへの依存度が増える.
- 家庭医学のモデルに転向し,全般医療従事者を採用する.
結論:
- 医療政策の決定は,証拠に基づいたものではなく,しばしば政治的に動機づけられました.
- 実施された健康改革の成功に関する証拠はほとんどありません.
- 国の経験から学ぶことは,将来の保健システム開発に不可欠です.
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