Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis

K. Dubas-Jakóbczyk (Coresponding Author), T. Albreht, D. Behmane, L. Bryndova, A. Dimova, A. Džakula, T. Habicht, L. Murauskiene, S. G. Scîntee, M. Smatana, Z. Velkey, W. Quentin

Research output: Contribution to journalReview articlepeer-review

6 Citations (Scopus)

Abstract

This paper aims to: (1) provide a brief overview of hospital sector characteristics in 11 Central and Eastern European countries (Bulgaria, Czech Republic, Estonia, Croatia, Latvia, Lithuania, Hungary, Poland, Romania, Slovakia, Slovenia); (2) compare recent (2008 – 2019) hospital reforms in these countries; and (3) identify common trends, success factors and challenges for reforms. Methods applied involved five stages: (1) a theoretical framework of hospital sector reforms was developed; (2) basic quantitative data characterizing hospital sectors were compared; (3) a scoping review was performed to identify an initial list of reforms per country; (4) the list was sent to national researchers who described the top three reforms based on a standardized questionnaire; (5) received questionnaires were analysed and validated with available literature. Results indicate that the scope of conducted reforms is very broad. Yet, reforms related to hospital sector governance and changes in purchasing and payment systems are much more frequent than reforms concerning relations with other providers. Most governance reforms aimed at transforming hospital infrastructure, improving financial management and/or improving quality of care, while purchasing and payment reforms focused on limiting hospital activities and/or on incentivising a shift to ambulatory/day care. Three common challenges included the lack of a comprehensive approach; unclear outcomes; and political influence. Given similar reform areas across countries, there is considerable potential for shared learning.

Original languageEnglish
Pages (from-to)368-379
Number of pages12
JournalHealth Policy
Volume124
Issue number4
DOIs
Publication statusPublished - Apr 2020

Keywords*

  • cross-country comparison
  • hospital
  • hospital governance
  • hospital payment
  • reform

Field of Science*

  • 3.3 Health sciences
  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

Fingerprint

Dive into the research topics of 'Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis'. Together they form a unique fingerprint.

Cite this