中欧和东欧以及前苏联的卫生改革
1European Observatory on Health Systems and Policies, London, UK. bernd.rechel@lshtm.ac.uk
Lancet (London, England)
|October 6, 2009
概括
欧洲前共产主义国家在柏林墙后改革了卫生系统,采用医疗保险和初级保健模式. 关于改革有效性的证据仍然有限,强调需要从经验中学习.
科学领域:
- 公共卫生 公共卫生
- 卫生政策 卫生政策
- 卫生系统研究 卫生系统研究
背景情况:
- 后共产主义的欧洲国家在20多年中经历了重大的卫生系统转型.
- 关键的变化包括普及医疗保险,增加自费支付和加强初级保健.
研究的目的:
- 描述前共产主义欧洲国家的重大卫生系统变化.
- 分析这些卫生改革的驱动因素和证据基础.
主要方法:
- 对卫生系统变化的描述性分析.
- 审查政策决策和有关改革成果的现有证据.
主要成果:
- 医疗保险系统的广泛采用.
- 更多地依赖于正式和非正式的自付支付.
- 转向与全科医生合作的家庭医学模型.
结论:
- 卫生政策决策往往是政治驱动的,而不是基于证据的.
- 关于实施的卫生改革取得成功的证据很少.
- 从国家经验中学习对于未来的卫生系统发展至关重要.
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