23 June 2009
Primary healthcare in the developing part of Europe: changes and development in the former Eastern Bloc countries that joined the European Union following 2004
Imre RurikABCDEFG, Laszlo KalabayCDEMed Sci Monit 2009; 15(7): PH78-84 :: ID: 869692
Abstract
Background
Primary care is an important tool to improve global health. This study presents an overview of how targets regarding primary care were realized in ten countries of the former Soviet Bloc that joined the EU since 2004.
Material and Method
Demographic, socioeconomic, and mortality-based statistical data are presented, scientific publications from the countries analyzed, and personal experiences of family physicians of these countries compared.
Results
After the collapse of communism, political changes and healthcare reforms began in these countries. There was economic recession and decline in the first decade. Life expectancies improved and total health expenditures increased to different extents, although governments spent barely more for healthcare. Primary care providers are the main private-sector contributors. The hospital-based structure changed, while the number of outpatient contacts is nearly the same. The ratio between secondary care specialists and family physicians remains too high and there is a shortage of educated nurses. Although new funding systems for primary care were introduced, budgets were mostly redistributed without substantial increases or improvement in outcome. The achievements of reform have rarely been evaluated systematically. Teamwork and praxis communities do not exist. The old style of polyclinics still predominates in some countries. The gate-keeping system is often symbolic or dysfunctional. Health promotion and prevention are rarely supported.
Conclusions
The implementation of family medicine is not an absolute priority for decision makers. The political situation is often unstable. Despite non-negligible achievements, the health systems in this part of Europe are still in the midst of transition.
Keywords: Life Expectancy, Primary Health Care - utilization, Health Resources - utilization, Europe, European Union - economics, Employment, Developing Countries - economics, Questionnaires
Editorial
01 July 2022 : Editorial
Editorial: World Health Organization (WHO) Variants of Concern Lineages Under Monitoring (VOC-LUM) in Response to the Global Spread of Lineages and Sublineages of Omicron, or B.1.1.529, SARS-CoV-2DOI: 10.12659/MSM.937676
Med Sci Monit 2022; 28:e937676
SARS-CoV-2/COVID-19
27 June 2022 : Clinical Research
Shoulder Injury Related to Vaccine Administration (SIRVA) in 16 Patients Following COVID-19 Vaccination Who...Med Sci Monit In Press; DOI: 10.12659/MSM.937430
04 June 2022 : Clinical Research
Screening for SARS-CoV-2 Infection in Students at the Medical University of Warsaw, Poland Between November...Med Sci Monit 2022; 28:e936962
30 May 2022 : Clinical Research
Effects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...Med Sci Monit 2022; 28:e936069
27 May 2022 : Clinical Research
Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)Med Sci Monit 2022; 28:e936547
In Press
01 Jul 2022 : Clinical Research
Does Early-Period Patient Dissatisfaction Turn Into Satisfaction Over Time After Total Knee Replacement?Med Sci Monit In Press; DOI: 10.12659/MSM.936792
30 Jun 2022 : Laboratory Research
Bcl-2 19-kDa Interacting Protein 3 (BNIP3)-Mediated Mitophagy Attenuates Intermittent Hypoxia-Induced Human...Med Sci Monit In Press; DOI: 10.12659/MSM.936760
30 Jun 2022 : Clinical Research
Antioxidant System and Ions Concentrations After Femoral Neck and Resurfacing Hip ArthroplastyMed Sci Monit In Press; DOI: 10.12659/MSM.936335
28 Jun 2022 : Meta-Analysis
Urodynamics in Early Diagnosis of Diabetic Bladder Dysfunction in Women: A Systematic Review and Meta-AnalysisMed Sci Monit In Press; DOI: 10.12659/MSM.937166
Most Viewed Current Articles
30 Dec 2021 : Clinical Research
Retrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...DOI :10.12659/MSM.935379
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review article
A Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...DOI :10.12659/MSM.936292
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review article
Long-Term Respiratory and Neurological Sequelae of COVID-19DOI :10.12659/MSM.928996
Med Sci Monit 2020; 26:e928996
13 Nov 2021 : Clinical Research
Acceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...DOI :10.12659/MSM.932788
Med Sci Monit 2021; 27:e932788