IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v60y2005i4p809-821.html
   My bibliography  Save this article

Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey

Author

Listed:
  • Gotsadze, George
  • Zoidze, Akaki
  • Vasadze, Otar

Abstract

The transition resulting from the break-up of the Soviet Union significantly affected the health care systems and population health status in the newly independent States. The available body of evidence suggests that contraction of public resources resulting from economic slowdown has led to the proliferation of out-of-pocket payments and private spending becoming a major source of finance to health service provision to the population. Emerging financial access barriers impede adequate utilization of health care services. Most transition countries embarked on reforming health systems and health care financing in order to tackle this problem. However, little evidence is available about the impact of these reforms on improved access and health outcomes. This paper aims to contribute to the assessment of the impact of health sector reforms in Georgia. It mainly focuses on changes in the patterns of health services utilization in rural areas of the country as a function of implemented changes in health care financing on a primary health care (PHC) level. Our findings are based on a household survey which was carried out during summer 2002. Conclusions derived from the findings could be of interest to policy makers in transitional countries. The paper argues that health financing reforms on the PHC level initiated by the Government of Georgia, aimed at decreasing financial access barriers for the population in the countryside, have rendered initial positive results and improved access to essential PHC services. However, to sustain and enhance this attainments the government should ensure equity, improve the targeting mechanisms for the poor and mobilize additional public and private funds for financing primary care in the country.

Suggested Citation

  • Gotsadze, George & Zoidze, Akaki & Vasadze, Otar, 2005. "Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey," Social Science & Medicine, Elsevier, vol. 60(4), pages 809-821, February.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:4:p:809-821
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(04)00284-9
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Belli, Paolo & Gotsadze, George & Shahriari, Helen, 2004. "Out-of-pocket and informal payments in health sector: evidence from Georgia," Health Policy, Elsevier, vol. 70(1), pages 109-123, October.
    2. World Bank, 2002. "Georgia : Public Expenditure Review," World Bank Publications - Reports 14539, The World Bank Group.
    3. David H. Peters & Abdo S. Yazbeck & Rashmi R. Sharma & G. N. V. Ramana & Lant H. Pritchett & Adam Wagstaff, 2002. "Better Health Systems for India's Poor : Findings, Analysis, and Options," World Bank Publications - Books, The World Bank Group, number 14080, December.
    4. Falkingham, Jane, 2004. "Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan," Social Science & Medicine, Elsevier, vol. 58(2), pages 247-258, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Obrizan, Maksym, 2019. "Diverging trends in health care use between 2010 and 2016: Evidence from three groups of transition countries," Economic Systems, Elsevier, vol. 43(1), pages 19-29.
    2. Obrizan, Maksym, 2017. "Does EU membership prevent crowding out of public health care? Evidence from 28 transition countries," MPRA Paper 81708, University Library of Munich, Germany.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Lewis, Maureen & Pettersson, Gunilla, 2009. "Governance in health care delivery : raising performance," Policy Research Working Paper Series 5074, The World Bank.
    2. Williams, Colin C. & Horodnic, Adrian V., 2017. "Rethinking informal payments by patients in Europe: An institutional approach," Health Policy, Elsevier, vol. 121(10), pages 1053-1062.
    3. Syed M. Ahsan & Syed Abdul Hamid & Shubhasish Barua, 2012. "Utilisation of Formal Health Care and Out-of-Pocket Payments in Rural Bangladesh," Working Papers 13, Institute of Microfinance (InM).
    4. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    5. Mæstad, Ottar & Mwisongo, Aziza, 2011. "Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers," Health Policy, Elsevier, vol. 99(2), pages 107-115, February.
    6. Elisabetta Reginato & Isabella Fadda & Paola Paglietti & Aldo Pavan, 2021. "Informal Payments and Performance in the Health Care Sector: Possible Relationships in a Sub-National Perspective," International Journal of Business and Management, Canadian Center of Science and Education, vol. 15(3), pages 126-126, July.
    7. Habibov, Nazim & Cheung, Alex, 2017. "Revisiting informal payments in 29 transitional countries: The scale and socio-economic correlates," Social Science & Medicine, Elsevier, vol. 178(C), pages 28-37.
    8. Nazim Habibov, 2011. "The inequity in out-of-pocket expenditures for healthcare in Tajikistan: evidence and implications from a nationally representative survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(4), pages 397-406, August.
    9. Habibov, Nazim, 2016. "Effect of corruption on healthcare satisfaction in post-soviet nations: A cross-country instrumental variable analysis of twelve countries," Social Science & Medicine, Elsevier, vol. 152(C), pages 119-124.
    10. Nikolaos Grigorakis & Christos Floros & Haritini Tsangari & Evangelos Tsoukatos, 2017. "Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 261-287, September.
    11. Singh, Dharmendra P. & Biradar, Rajeshwari A. & Halli, Shiva S. & Dwivedi, Laxmi Kant, 2021. "Effect of maternal nutritional status on children nutritional status in India," Children and Youth Services Review, Elsevier, vol. 120(C).
    12. Ilhom Abdulloev & Ira N. Gang & John Landon-Lane, 2011. "Migration as a Substitute for Informal Activities: Evidence from Tajikistan," Working Papers 311, Leibniz Institut für Ost- und Südosteuropaforschung (Institute for East and Southeast European Studies).
    13. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    14. Dayashankar Maurya, 2019. "Understanding public health insurance in India: A design perspective," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1633-1650, October.
    15. Alassane DRABO & Christian EBEKE, 2010. "Remittances, Public Health Spending and Foreign Aid in the Access to Health Care Services in Developing Countries," Working Papers 201004, CERDI.
    16. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    17. Alok Bhargava & Sadia Chowdhury & K. K. Singh, 2006. "Healthcare infrastructure, contraceptive use and infant mortality in Uttar Pradesh, India," World Scientific Book Chapters, in: Econometrics, Statistics And Computational Approaches In Food And Health Sciences, chapter 23, pages 319-335, World Scientific Publishing Co. Pte. Ltd..
    18. Bonu, Sekhar & Rani, Manju & Jha, Prabhat & Peters, David H. & Nguyen, Son Nam, 2004. "Household tobacco and alcohol use, and child health: an exploratory study from India," Health Policy, Elsevier, vol. 70(1), pages 67-83, October.
    19. Gaal, Peter & McKee, Martin, 2005. "Fee-for-service or donation? Hungarian perspectives on informal payment for health care," Social Science & Medicine, Elsevier, vol. 60(7), pages 1445-1457, April.
    20. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2015. "Out-of-pocket payments for health care in Serbia," Health Policy, Elsevier, vol. 119(10), pages 1366-1374.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:60:y:2005:i:4:p:809-821. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.