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Getting Better : Improving Health System Outcomes in Europe and Central Asia

  • Owen Smith
  • Son Nam Nguyen
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    This report is about how to improve health system outcomes in countries in the Europe and Central Asia (ECA) region. Long-term historical trends indicate substantial room for improvement, especially when ECA's health outcomes are compared to those of the Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, and the United Kingdom (EU-15). Instead of catching up with their Western neighbors, many countries in ECA have been falling behind. This report, which explores the development challenge facing health sectors in ECA, identifies three key agendas for achieving more rapid convergence with the world's best-performing health systems: (i) the first is the health agenda, in which the main imperative is to strengthen public health and primary care interventions to help achieve the 'cardiovascular revolution' that has taken place in the west in recent decades; (ii) the second is the financing agenda, in which growing demand for medical care must be satisfied without imposing an undue burden on households, by achieving better financial protection, or on government budgets, by ensuring a more efficient use of resources; and (iii) the third agenda relates to broader institutional arrangements. Here, a few key reform ingredients are identified, each of which is common to most advanced health systems but lacking in many ECA countries.

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    This book is provided by The World Bank in its series World Bank Publications with number 13832 and published in 2013.
    ISBN: 978-0-8213-9883-8
    Handle: RePEc:wbk:wbpubs:13832
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    Web page: https://openknowledge.worldbank.org
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    1. Wagstaff, Adam & Moreno-Serra, Rodrigo, 2009. "Europe and central Asia's great post-communist social health insurance experiment: Aggregate impacts on health sector outcomes," Journal of Health Economics, Elsevier, vol. 28(2), pages 322-340, March.
    2. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517.
    3. Andrea M. Leiter & Engelbert Theurl, 2009. "The Convergence of Health Care Financing Structures: Empirical Evidence from OECD-Countries," Working Papers 2009-20, Faculty of Economics and Statistics, University of Innsbruck.
    4. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Economics Department Working Papers 374, OECD Publishing.
    5. Martin Gaynor & Robert J Town, 2012. "Competition in Health Care Markets," The Centre for Market and Public Organisation 12/282, Department of Economics, University of Bristol, UK.
    6. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2009. "System-wide impacts of hospital payment reforms : evidence from central and eastern Europe and central Asia," Policy Research Working Paper Series 4987, The World Bank.
    7. David M. Cutler & Richard J. Zeckhauser, 1999. "The Anatomy of Health Insurance," NBER Working Papers 7176, National Bureau of Economic Research, Inc.
    8. Alexander S. Preker & April Harding, 2003. "Innovations in Health Service Delivery : The Corporatization of Public Hospitals," World Bank Publications, The World Bank, number 15145.
    9. Valérie Paris & Marion Devaux & Lihan Wei, 2010. "Health Systems Institutional Characteristics: A Survey of 29 OECD Countries," OECD Health Working Papers 50, OECD Publishing.
    10. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128.
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