Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey
Reform strategies in Georgia and their impact on health care provision in rural areas: evidence from a household survey
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DOI：
10.1016/j.socscimed.2004.06.017
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发表时间：
2005-02-01
影响因子：
5.4
通讯作者：
Vasadze, O
中科院分区：
文献类型：
--
作者：
Gotsadze, G;Zoidze, A;Vasadze, O
苏联解体后的过渡对新独立国家的保健系统和人口健康状况产生了重大影响。现有大量证据表明，经济放缓导致公共资源紧缩，导致自付费用激增，私人支出成为向民众提供保健服务的主要资金来源。新出现的获得资金的障碍阻碍了充分利用保健服务。大多数转型期国家着手改革保健系统和保健筹资，以解决这一问题。然而.几乎没有证据表明这些改革对改善获得和卫生成果的影响。本文旨在为评估格鲁吉亚卫生部门改革的影响做出贡献。它主要侧重于该国农村地区保健服务利用模式的变化，这是在初级保健一级保健筹资方面实施变化的一个功能。我们的调查结果是根据2002年夏季进行的一项住户调查得出的。从调查结果得出的结论可能是转型期国家的政策制定者感兴趣的。本文认为，卫生筹资改革的初级保健水平发起的格鲁吉亚政府。旨在减少农村人口获得金融服务的障碍。取得了初步的积极成果，改善了获得基本初级保健服务的机会。然而，为了保持和加强这一成就，政府应确保公平，改善针对穷人的机制，并调动更多的公共和私人资金，为该国的初级保健提供资金。(C)2004爱思唯尔有限公司保留所有权利。
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. (C) 2004 Elsevier Ltd. All rights reserved.