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Patient and provider perspectives on quality and health system effectiveness in a transition economy: Evidence from Ukraine

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  • Luck, J.
  • Peabody, J.W.
  • DeMaria, L.M.
  • Alvarado, C.S.
  • Menon, R.

Abstract

Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV® vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV® results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies would align the incentives of physicians with the desires of the population they serve.

Suggested Citation

  • Luck, J. & Peabody, J.W. & DeMaria, L.M. & Alvarado, C.S. & Menon, R., 2014. "Patient and provider perspectives on quality and health system effectiveness in a transition economy: Evidence from Ukraine," Social Science & Medicine, Elsevier, vol. 114(C), pages 57-65.
    • Handle: RePEc:eee:socmed:v:114:y:2014:i:c:p:57-65
    DOI: 10.1016/j.socscimed.2014.05.034
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    1. Mackenbach, Johan P. & Hu, Yannan & Looman, Caspar W.N., 2013. "Democratization and life expectancy in Europe, 1960–2008," Social Science & Medicine, Elsevier, vol. 93(C), pages 166-175.
    2. Salman Zaidi & Asad Alam & Pradeep Mitra & Ramya Sundaram, 2009. "Satisfaction with Life and Service Delivery in Eastern Europe and the Former Soviet Union : Some Insights from the 2006 Life in Transition Survey," World Bank Publications - Books, The World Bank Group, number 5955, December.
    3. Gordeev, Vladimir S. & Pavlova, Milena & Groot, Wim, 2011. "Two decades of reforms. Appraisal of the financial reforms in the Russian public healthcare sector," Health Policy, Elsevier, vol. 102(2), pages 270-277.
    4. Ensor, Tim, 2004. "Informal payments for health care in transition economies," Social Science & Medicine, Elsevier, vol. 58(2), pages 237-246, January.
    5. Atkinson, Sarah & Haran, Dave, 2005. "Individual and district scale determinants of users' satisfaction with primary health care in developing countries," Social Science & Medicine, Elsevier, vol. 60(3), pages 501-513, February.
    6. Footman, Katharine & Roberts, Bayard & Mills, Anne & Richardson, Erica & McKee, Martin, 2013. "Public satisfaction as a measure of health system performance: A study of nine countries in the former Soviet Union," Health Policy, Elsevier, vol. 112(1), pages 62-69.
    7. Kruk, Margaret Elizabeth & Porignon, Denis & Rockers, Peter C. & Van Lerberghe, Wim, 2010. "The contribution of primary care to health and health systems in low- and middle-income countries: A critical review of major primary care initiatives," Social Science & Medicine, Elsevier, vol. 70(6), pages 904-911, March.
    8. Gaal, Peter & Evetovits, Tamas & McKee, Martin, 2006. "Informal payment for health care: Evidence from Hungary," Health Policy, Elsevier, vol. 77(1), pages 86-102, June.
    9. Geltzer, Anna, 2009. "When the standards aren't standard: Evidence-based medicine in the Russian context," Social Science & Medicine, Elsevier, vol. 68(3), pages 526-532, February.
    10. Kersnik, Janko, 2001. "Determinants of customer satisfaction with the health care system, with the possibility to choose a personal physician and with a family doctor in a transition country," Health Policy, Elsevier, vol. 57(2), pages 155-164, August.
    11. 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.
    12. Akinci, Fevzi & Mollahaliloğlu, Salih & Gürsöz, Hakki & Öğücü, Fatma, 2012. "Assessment of the Turkish health care system reforms: A stakeholder analysis," Health Policy, Elsevier, vol. 107(1), pages 21-30.
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    2. Le, Nga & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2018. "Health insurance and patient satisfaction: Evidence from the poorest regions of Vietnam," MERIT Working Papers 2018-040, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).

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