IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v124y2020i4p368-379.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851020300385
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2020.02.003?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    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. Christoph Schwierz, 2016. "Cost-Containment Policies in Hospital Expenditure in the European Union," European Economy - Discussion Papers 037, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    2. Callea, Giuditta & Armeni, Patrizio & Marsilio, Marta & Jommi, Claudio & Tarricone, Rosanna, 2017. "The impact of HTA and procurement practices on the selection and prices of medical devices," Social Science & Medicine, Elsevier, vol. 174(C), pages 89-95.
    3. Kastanioti, Catherine & Kontodimopoulos, Nick & Stasinopoulos, Dionysis & Kapetaneas, Nikolaos & Polyzos, Nikolaos, 2013. "Public procurement of health technologies in Greece in an era of economic crisis," Health Policy, Elsevier, vol. 109(1), pages 7-13.
    4. Giuseppe Carone & Christoph Schwierz & Ana Xavier, 2012. "Cost-containment policies in public pharmaceutical spending in the EU," European Economy - Economic Papers 2008 - 2015 461, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    5. Bertezene, Sandra, 2018. "Control of hospitals and nursing homes in France: The 2016 reform may indirectly improve a dysfunctional system," Health Policy, Elsevier, vol. 122(4), pages 329-333.
    6. Przemyslaw Marcin Sowa, 2016. "Governance of Hospitals in Central and Eastern Europe," Springer Books, Springer, edition 1, number 978-981-287-766-6, January.
    7. Achim Schmid & Ralf Götze, 2009. "Cross‐national policy learning in health system reform: The case of Diagnosis Related Groups," International Social Security Review, John Wiley & Sons, vol. 62(4), pages 21-40, October.
    8. Sorenson, Corinna & Kanavos, Panos, 2011. "Medical technology procurement in Europe: A cross-country comparison of current practice and policy," Health Policy, Elsevier, vol. 100(1), pages 43-50, April.
    9. Healy, Judith & McKee, Martin, 2002. "Implementing hospital reform in central and eastern Europe," Health Policy, Elsevier, vol. 61(1), pages 1-19, July.
    10. Camilla Mastromarco & Lenka Stastna & Jana Votapkova, 2019. "Efficiency of hospitals in the Czech Republic: Conditional efficiency approach," Journal of Productivity Analysis, Springer, vol. 51(1), pages 73-89, February.
    11. Jacek Klich, 2015. "Health Care Systems’ Evolvement and the Changing Role of the State in Selected CEEC," Working Papers 61/2015, Institute of Economic Research, revised Apr 2015.
    12. Simona Baldi & Davide Vannoni, 2017. "The impact of centralization on pharmaceutical procurement prices: the role of institutional quality and corruption," Regional Studies, Taylor & Francis Journals, vol. 51(3), pages 426-438, March.
    13. Clemens, Timo & Michelsen, Kai & Commers, Matt & Garel, Pascal & Dowdeswell, Barrie & Brand, Helmut, 2014. "European hospital reforms in times of crisis: Aligning cost containment needs with plans for structural redesign?," Health Policy, Elsevier, vol. 117(1), pages 6-14.
    14. Scîntee, Silvia Gabriela & Vlădescu, Cristian & Sagan, Anna & Hernández-Quevedo, Cristina, 2018. "The unexpected outcomes of the closure of 67 inpatient care facilities in 2011 in Romania," Health Policy, Elsevier, vol. 122(11), pages 1161-1164.
    15. Dubas-Jakóbczyk, Katarzyna & Kowalska-Bobko, Iwona & Sowada, Christoph, 2019. "The 2017 reform of the hospital sector in Poland – The challenge of consistent design," Health Policy, Elsevier, vol. 123(6), pages 538-543.
    16. Katarzyna Dubas‐Jakóbczyk & Christoph Sowada & Alicja Domagała & Barbara Więckowska, 2018. "Building hospital capacity planning mechanisms in Poland: The impact of 2016/2017 regulatory changes," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(2), pages 403-415, April.
    17. Bravi, F. & Gibertoni, D. & Marcon, A. & Sicotte, C. & Minvielle, E. & Rucci, P. & Angelastro, A. & Carradori, T. & Fantini, M.P., 2013. "Hospital network performance: A survey of hospital stakeholders’ perspectives," Health Policy, Elsevier, vol. 109(2), pages 150-157.
    18. De Regge, Melissa & De Pourcq, Kaat & Van de Voorde, Carine & Van den Heede, Koen & Gemmel, Paul & Eeckloo, Kristof, 2019. "The introduction of hospital networks in Belgium: The path from policy statements to the 2019 legislation," Health Policy, Elsevier, vol. 123(7), pages 601-605.
    19. Rechel, Bernd & Džakula, Aleksandar & Duran, Antonio & Fattore, Giovanni & Edwards, Nigel & Grignon, Michel & Haas, Marion & Habicht, Triin & Marchildon, Gregory P. & Moreno, Antonio & Ricciardi, Walt, 2016. "Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries," Health Policy, Elsevier, vol. 120(7), pages 758-769.
    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. Messerle, Robert & Schreyögg, Jonas, 2022. "System-wide effects of hospital payment scheme reforms: The German introduction of diagnosis-related groups," hche Research Papers 26, University of Hamburg, Hamburg Center for Health Economics (hche).
    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.

    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. 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.
    2. Miller, Fiona A. & Lehoux, Pascale & Rac, Valeria E. & Bytautas, Jessica P. & Krahn, Murray & Peacock, Stuart, 2020. "Modes of coordination for health technology adoption: Health Technology Assessment agencies and Group Procurement Organizations in a polycentric regulatory regime," Social Science & Medicine, Elsevier, vol. 265(C).
    3. Katarzyna Dubas‐Jakóbczyk & Alicja Domagała & Marcin Mikos, 2019. "Impact of the doctor deficit on hospital management in Poland: A mixed‐method study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 187-195, January.
    4. Kosycarz, Ewa & Dędys, Monika & Ekes, Maria & Wranik, Wiesława Dominika, 2023. "The effects of provider contract types and fiscal decentralization on the efficiency of the Polish hospital sector: A data envelopment analysis across 16 health regions," Health Policy, Elsevier, vol. 129(C).
    5. 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.
    6. Denita Cepiku & Fabio Marinangeli & Benedetta Marchese, 2019. "La centralizzazione degli acquisti in sanit?: esperienze di approvvigionamento del servizio di ossigenoterapia domiciliare nel Lazio," MECOSAN, FrancoAngeli Editore, vol. 2019(111), pages 7-33.
    7. 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.
    8. 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).
    9. Callea, Giuditta & Armeni, Patrizio & Marsilio, Marta & Jommi, Claudio & Tarricone, Rosanna, 2017. "The impact of HTA and procurement practices on the selection and prices of medical devices," Social Science & Medicine, Elsevier, vol. 174(C), pages 89-95.
    10. Simona Baldi & Davide Vannoni, 2014. "The Impact of Centralization, Corruption and Institutional Quality on Procurement Prices: An Application to Pharmaceutical Purchasing in Italy," Carlo Alberto Notebooks 379, Collegio Carlo Alberto.
    11. Bucciol, Alessandro & Camboni, Riccardo & Valbonesi, Paola, 2020. "Purchasing medical devices: The role of buyer competence and discretion," Journal of Health Economics, Elsevier, vol. 74(C).
    12. Goranitis, Ilias & Siskou, Olga & Liaropoulos, Lycourgos, 2014. "Health policy making under information constraints: An evaluation of the policy responses to the economic crisis in Greece," Health Policy, Elsevier, vol. 117(3), pages 279-284.
    13. Grepperud, Sverre & Pedersen, Pål Andreas, 2020. "Positioning and negotiations: The case of pharmaceutical pricing," European Journal of Political Economy, Elsevier, vol. 62(C).
    14. Simona Baldi & Davide Vannoni, 2017. "The impact of centralization on pharmaceutical procurement prices: the role of institutional quality and corruption," Regional Studies, Taylor & Francis Journals, vol. 51(3), pages 426-438, March.
    15. Birg, Laura, 2019. "Parallel imports and manufacturer rebates: Evidence from Germany," University of Göttingen Working Papers in Economics 363, University of Goettingen, Department of Economics.
    16. Fangye Du & Jiaoe Wang & Haitao Jin, 2021. "Whether Public Hospital Reform Affects the Hospital Choices of Patients in Urban Areas: New Evidence from Smart Card Data," IJERPH, MDPI, vol. 18(15), pages 1-14, July.
    17. Braendle, Thomas & Colombier, Carsten, 2020. "Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad," Health Policy, Elsevier, vol. 124(6), pages 605-614.
    18. Robert Messerle & Jonas Schreyögg, 2024. "Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 1013-1030, August.
    19. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    20. Salas-Vega, Sebastian & Shearer, Emily & Mossialos, Elias, 2020. "Relationship between costs and clinical benefits of new cancer medicines in Australia, France, the UK, and the US," Social Science & Medicine, Elsevier, vol. 258(C).

    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:hepoli:v:124:y:2020:i:4:p:368-379. 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 or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    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.