Richardson Erica, Malakhova Irina, Novik Irina, Famenka Andrei
European Observatory on health Systems and Policies.
Republican Scientific and Practical Centre for Medical Technologies, Informatization, Administration and Management of Health (RSPC MT).
Health Syst Transit. 2013;15(5):1-118.
This analysis of the Belarusian health system reviews the developments in organization and governance, health financing, healthcare provision, health reforms and health system performance since 2008. Despite considerable change since independence, Belarus retains a commitment to the principle of universal access to health care, provided free at the point of use through predominantly state-owned facilities, organized hierarchically on a territorial basis. Incremental change, rather than radical reform, has also been the hallmark of health-care policy, although capitation funding has been introduced in some areas and there have been consistent efforts to strengthen the role of primary care. Issues of high costs in the hospital sector and of weaknesses in public health demonstrate the necessity of moving forward with the reform programme. The focus for future reform is on strengthening preventive services and improving the quality and efficiency of specialist services. The key challenges in achieving this involve reducing excess hospital capacity, strengthening health-care management, use of evidence-based treatment and diagnostic procedures, and the development of more efficient financing mechanisms. Involving all stakeholders in the development of further reform planning and achieving consensus among them will be key to its success.
对白俄罗斯卫生系统的这一分析回顾了自2008年以来在组织与治理、卫生筹资、医疗服务提供、卫生改革及卫生系统绩效方面的发展情况。尽管自独立以来发生了相当大的变化，但白俄罗斯仍坚持全民享有医疗保健的原则，通过主要为国有且按地域层级组织的设施在使用点免费提供医疗服务。渐进式变革而非激进式改革也一直是医疗保健政策的特点，尽管在一些领域引入了按人头付费资金，并且一直在持续努力加强初级保健的作用。医院部门的高成本问题和公共卫生方面的薄弱环节表明推进改革方案的必要性。未来改革的重点是加强预防服务以及提高专科服务的质量和效率。实现这一目标的关键挑战包括减少医院过度的床位、加强医疗保健管理、采用循证治疗和诊断程序以及发展更有效的筹资机制。让所有利益相关者参与进一步改革规划的制定并在他们之间达成共识将是改革成功的关键。
