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经济危机作为医疗保健系统变革的动因——以新冠疫情为参照的历史视角

ECONOMIC CRISES AS A MOTIVE FOR CHANGE IN HEALTH CARE SYSTEMS - A HISTORICAL PERSPECTIVE WITH REFERENCE TO THE COVID-19 PANDEMIC.

作者信息

Kaštelan Snježana, Kasun Boris, Kaštelan Uršula, Radonjić Milena, Sopta Martina

机构信息

Department of Ophthalmology, Clinical Hospital Dubrava, Zagreb; School of Medicine, University of Zagreb. E-mail:

Department of Historical and Geographic Sciences and the Ancient World, School of Human and Social Sciences and Cultural Heritage, University of Padova, Padova, Italy.

出版信息

Acta Med Hist Adriat. 2021 Jan 20;18(2):355-374. doi: 10.31952/amha.18.2.8.

Abstract

Economic crises throughout history have often given an impetus for health and social reforms leading to the introduction of general healthcare systems and social equality in a large number of countries. The aim of this paper is to present the major economic crises and their effect on healthcare and social system chronologically. Bismarck's and Beveridge's model, the two most prominent healthcare models, which emerged primarily as a response to major economic crises, constitute the basis for the functioning of most health care systems in the world. An overview of historical events and experiences may be valuable in predicting future developments and potential effects of the crisis on healthcare systems and health in general. An analysis of past crises as well as current health and economic crisis caused by the COVID-19 pandemic and their impact on the healthcare system can facilitate the comprehension of the mechanisms of action and consequences of economic recession. It may also help identify guidelines and changes that might reduce the potential damage caused by future crises. The historical examples presented show that a crisis could trigger changes, which, in theiressence, are not necessarily negative. The response of society as a whole determines the direction of these changes, and it is up to society to transform the negative circumstances brought about by the recession into activities that contribute to general well-being and progress.

摘要

历史上的经济危机常常推动健康与社会改革,促使大量国家引入全民医疗体系并实现社会平等。本文旨在按时间顺序呈现主要的经济危机及其对医疗和社会体系的影响。俾斯麦模式和贝弗里奇模式是两种最著名的医疗模式,它们主要是作为对重大经济危机的回应而出现的,构成了世界上大多数医疗体系运作的基础。回顾历史事件和经验对于预测危机对医疗体系及总体健康的未来发展和潜在影响可能具有重要价值。分析过去的危机以及由新冠疫情引发的当前健康与经济危机及其对医疗体系的影响,有助于理解经济衰退的作用机制和后果。这也可能有助于确定能够减少未来危机潜在损害的指导方针和变革。文中呈现的历史事例表明,危机可能引发变革,而这些变革本质上不一定是负面的。整个社会的应对方式决定了这些变革的方向,而将衰退带来的负面状况转化为有助于总体福祉和进步的活动,这取决于社会自身。

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