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

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

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.

Suggested Citation

  • Dubas-Jakóbczyk, K. & Albreht, T. & Behmane, D. & Bryndova, L. & Dimova, A. & Džakula, A. & Habicht, T. & Murauskiene, L. & Scîntee, S.G. & Smatana, M. & Velkey, Z. & Quentin, W., 2020. "Hospital reforms in 11 Central and Eastern European countries between 2008 and 2019: a comparative analysis," Health Policy, Elsevier, vol. 124(4), pages 368-379.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:4:p:368-379
    DOI: 10.1016/j.healthpol.2020.02.003
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    Cited by:

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    2. Katarzyna Dubas-Jakóbczyk & Ewa Kocot & Anna Kozieł, 2020. "Financial Performance of Public Hospitals: A Cross-Sectional Study among Polish Providers," IJERPH, MDPI, vol. 17(7), pages 1-14, March.
    3. Katarzyna Dubas-Jakóbczyk & Anna Kozieł, 2020. "Towards Financial Sustainability of the Hospital Sector in Poland—A Post Hoc Evaluation of Policy Approaches," Sustainability, MDPI, vol. 12(12), pages 1-19, June.
    4. Dubas-Jakóbczyk, Katarzyna & Domagała, Alicja & Zabdyr-Jamróz, Michał & Kowalska-Bobko, Iwona & Sowada, Christoph, 2023. "The 2021 plan for hospital care centralization in Poland – When politics overwhelms the policy process," Health Policy, Elsevier, vol. 129(C).
    5. Baumann, Aron & Wyss, Kaspar, 2021. "The shift from inpatient care to outpatient care in Switzerland since 2017: Policy processes and the role of evidence," Health Policy, Elsevier, vol. 125(4), pages 512-519.
    6. Polin, Katherine & Hjortland, Maximilien & Maresso, Anna & van Ginneken, Ewout & Busse, Reinhard & Quentin, Wilm, 2021. "“Top-Three” health reforms in 31 high-income countries in 2018 and 2019: an expert informed overview," Health Policy, Elsevier, vol. 125(7), pages 815-832.

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