Oreskovic S
Andrija Stampar School of Public Health, Zagreb University School of Medicine, 10000 Zagreb, Croatia.
Croat Med J. 1998 Sep;39(3):225-33.
After the breakdown of the state socialism, a number of changes have occurred in the legal framework, as well as governmental policy, ownership, production, financing, and reimbursement of health care in Central and Eastern Europe (CEE). However, the policy context in CEE makes priority setting a necessary step to ensure the efficient use of public funds for health. The problems with prioritizing of health services in the Central and Eastern Europe are, in essence, related to the general position of health care within broad national priorities. The percentage of gross domestic product spent on health is insufficient and many cost-effective interventions are currently neglected, under-funded or provided with low quality standards. If the health status is to be improved, such interventions should be granted a greater priority. The experience from the established market economies indicate that: (a) overall future system of priorities setting in health care in the CEE should be driven by new democratic values; (b) new systems must be people-centered, more oriented to the needs of individual patient and specific groups, and sensitive to inequalities, unemployment, and social poverty; (c) they should be health-focused; and (d) they should be evidence-based and oriented towards primary health care.
在国家社会主义解体后，中东欧地区的法律框架以及政府政策、医疗保健的所有权、生产、融资和报销等方面都发生了一些变化。然而，中东欧地区的政策背景使得确定优先事项成为确保有效利用公共卫生资金的必要步骤。中东欧地区卫生服务优先排序的问题，本质上与医疗保健在国家总体优先事项中的总体地位有关。用于卫生的国内生产总值百分比不足，许多具有成本效益的干预措施目前被忽视、资金不足或质量标准低下。如果要改善健康状况，就应给予这些干预措施更高的优先级。成熟市场经济体的经验表明：(a) 中东欧地区未来卫生保健总体优先事项设定体系应以新的民主价值观为导向；(b) 新体系必须以人为本，更加关注个体患者和特定群体的需求，并对不平等、失业和社会贫困问题保持敏感；(c) 它们应以健康为重点；(d) 它们应以证据为基础，并以初级卫生保健为导向。
