Web-economic-crisis-health-systems-and-health-web

More documents

Recommendations

Info

Chapter 2 | The impact of the crisis on the health system and health in Estonia 71 planned for a long time. This relative success is in part because of the ability of the health system itself to absorb shock, but also because the crisis in Estonia was relatively short in duration and the economy recovered much faster than in most of the other hard-hit countries of western Europe. Appendix 2.1 Major crisis-related events and changes in the Estonian health system, 2009–2013 Date Event/action 2009 The central government health budget, which accounts for approximately 10% of total health spending, was cut by 26% The EHIF’s revenues (social health insurance contributions) fell by 11%, mainly through increased unemployment and lower salaries The EHIF reduced its budget expenditures by e70 million (8%) compared to 2008 A radical reform of temporary sickness benefits, which now included employers paying some of the benefit and reductions to the benefit rates, resulted in considerable savings and funds being released to the EHIF to pay for health services Prices/tariffs paid to health care providers were reduced by 6%, leading to significant savings for the EHIF As part of health providers tariff cuts, salaries of health professionals fell, mainly through cuts in overtime and by standardizing working hours to 8 hours per day The previously universal adult dental care cash benefit became restricted to insured people aged over 63 and some other groups, such as pregnant women and mothers with infants under 12 months VAT for medicines increased from 5% to 9% 2010 The unemployment rate reached 17.3%, triple that of 2007 The EHIF’s revenues (social health insurance contributions) fell by 5% A 15% co-insurance rate was introduced for nursing inpatient care Tariff agreements and reference pricing was extended to pharmaceuticals in the lowest (50%) reimbursement category (which contains many less cost-effective drugs) A ministerial decree encouraged prescribing and dispensing by active ingredient Pharmacists became required to provide patients with the drug with the lowest level of cost sharing A new e-prescription system was launched to operate alongside paper prescribing 2011 The unemployment rate improved to 12.8% EHIF revenue increased by 6% Prices/tariffs paid to all health care providers were still at a reduced rate (of 5%) except for primary care, where the price cut was 3%
72 Economic crisis, health systems and health in Europe: country experience Major crisis-related events and changes in the Estonian health system, 2009–2013 (continued) Date Event/action 2012 Unemployment stabilized at 10.2% EHIF revenue again increased by 6% User charges for outpatient specialist visits increased from e3.20 to e5.00 and the bed-day fee from e1.60 to e2.50 Prices/tariffs paid to health care providers were restored to original pre-crisis levels The reimbursement cap per prescription of 50% for reimbursed pharmaceuticals was removed, reducing patients’ user charges 2013 Prices/tariffs paid to health care providers were increased after a physicians’ strike Acknowledgements The authors are grateful to Ms Annika Veimer from the National Institute for Health Development for a useful description on the impact of the crisis on public health programmes and to Mr Tanel Ross from the Estonian Health Insurance Fund for valuable comments on the draft version. References EHIF (2008). Annual report 2007. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (http://www.haigekassa.ee/eng/ehif/annual, accessed 19 October 2014). EHIF (2009). Annual report 2009. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (www.haigekassa.ee/uploads/userfiles/file/ENG/Eesti_Haigekassa_ majandusaasta_aruanne_2009_eng.pdf, accessed 19 October 2014). EHIF (2012a). Annual report 2011. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (http://www.haigekassa.ee/eng/ehif/annual, accessed 19 October 2014). EHIF (2012b). Hospital Master Plan hospitals feedback report. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (http://www.haigekassa.ee/raviasutusele/ kvaliteet/tagasiside, accessed 29 October 2014). EHIF (2013). Annual report 2007. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (http://www.haigekassa.ee/eng/ehif/annual, accessed 19 October 2014). EHIF and Ministry of Social Affairs (2014). Public evaluation of health and health care 2007–2011. Tallinn, Eesti Haigekassa [Estonian Health Insurance Fund] (http://www.haigekassa.ee/haigekassa/uuringud/, accessed 29 October 2014).
Page 1 and 2:
Economic crisis, health systems and
Page 3 and 4:
The European Observatory on Health
Page 5 and 6:
Keywords: DELIVERY OF HEALTH CARE E
Page 7 and 8:
vi Economic crisis, health systems
Page 9 and 10:
viii Economic crisis, health system
Page 11 and 12:
List of abbreviations ACS Health in
Page 13 and 14:
List of tables and figures Tables P
Page 15 and 16:
xiv Economic crisis, health systems
Page 17 and 18:
xvi Economic crisis, health systems
Page 19 and 20:
xviii Economic crisis, health syste
Page 21 and 22:
xx Economic crisis, health systems
Page 23 and 24:
xxii Economic crisis, health system
Page 25 and 26:
xxiv Economic crisis, health system
Page 27 and 28:
xxvi Economic crisis, health system
Page 29 and 30:
Acknowledgements This book represen
Page 31 and 32:
Preface This book maps health polic
Page 34:
Part I Country case studies
Page 37 and 38:
4 Economic crisis, health systems a
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
10 Economic crisis, health systems
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54: 20 Economic crisis, health systems
Page 103: 70 Economic crisis, health systems
Page 136 and 137: Chapter 4 The impact of the crisis
Page 138 and 139: Chapter 4 | The impact of the crisi
Page 154 and 155:
Chapter 4 | The impact of the crisi
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Chapter 5 The impact of the crisis
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Page 188 and 189:
Page 190 and 191:
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Page 198 and 199:
Page 200 and 201:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228:
Page 229 and 230:
Page 231 and 232:
Page 233 and 234:
Page 235 and 236:
Page 237 and 238:
Page 239 and 240:
Page 241 and 242:
Page 243 and 244:
Page 245 and 246:
Page 247 and 248:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
Page 258 and 259:
Page 260 and 261:
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 316 and 317:
Page 318 and 319:
Page 320 and 321:
Page 322 and 323:
Page 324 and 325:
Page 326 and 327:
Page 328 and 329:
Page 330 and 331:
Page 332 and 333:
Page 334 and 335:
Page 336 and 337:
Page 338 and 339:
Page 340 and 341:
Page 342 and 343:
Page 344 and 345:
Page 346 and 347:
Page 348 and 349:
Page 350 and 351:
Page 352:
Page 356 and 357:
Albania Genc Burazeri and Enver Ros
Page 358 and 359:
Country profiles of health system r
Page 360 and 361:
Page 362 and 363:
Austria Thomas Czypionka and Maria
Page 364 and 365:
Page 366 and 367:
Azerbaijan Fuad Ibrahimov Economic
Page 368 and 369:
Page 370 and 371:
Page 372 and 373:
Page 374 and 375:
Page 376 and 377:
Page 378 and 379:
Page 380 and 381:
Page 382 and 383:
Bulgaria Antoniya Dimova and Mina P
Page 384 and 385:
Page 386 and 387:
Page 388 and 389:
Page 390 and 391:
Cyprus Elisavet Constantinou and Ma
Page 392 and 393:
Page 394 and 395:
Czech Republic Tomáš Roubal and J
Page 396 and 397:
Page 398 and 399:
Page 400 and 401:
Page 402 and 403:
Page 404 and 405:
Estonia Triin Habicht and Mall Lein
Page 406 and 407:
Page 408 and 409:
Finland Jan Klavus and Lauri Vuoren
Page 410 and 411:
Page 412 and 413:
France Karine Chevreul, Karen Berg
Page 414 and 415:
Page 416 and 417:
Page 418 and 419:
Page 420 and 421:
Germany Klaus-Dirk Henke and Wilm Q
Page 422 and 423:
Page 424 and 425:
Page 426 and 427:
Page 428 and 429:
Page 430 and 431:
Page 432 and 433:
Page 434 and 435:
Iceland Sigrún Gunnarsdóttir and
Page 436 and 437:
Page 438 and 439:
Ireland Anne Nolan and Steve Thomas
Page 440 and 441:
Page 442 and 443:
Page 444 and 445:
Israel Bruce Rosen and Amir Shmueli
Page 446 and 447:
Page 448 and 449:
Page 450 and 451:
Page 452 and 453:
Kazakhstan Ninel Kadyrova and Tata
Page 454 and 455:
Page 456 and 457:
Page 458 and 459:
Latvia Uldis Mitenbergs and Maris T
Page 460 and 461:
Page 462 and 463:
Page 464 and 465:
Page 466 and 467:
Page 468 and 469:
Page 470 and 471:
Malta Natasha Azzopardi Muscat Econ
Page 472 and 473:
Page 474 and 475:
Page 476 and 477:
Page 478 and 479:
Montenegro Ratka Knežević Economi
Page 480 and 481:
Page 482 and 483:
Page 484 and 485:
Page 486 and 487:
Norway Anne Karin Lindahl and Jon M
Page 488 and 489:
Page 490 and 491:
Page 492 and 493:
Page 494 and 495:
Page 496 and 497:
Page 498 and 499:
Page 500 and 501:
Page 502 and 503:
Page 504 and 505:
The Russian Federation Elena Potapc
Page 506 and 507:
Page 508 and 509:
Serbia Vukasin Radulovic Economic t
Page 510 and 511:
Page 512 and 513:
Page 514 and 515:
Page 516 and 517:
Page 518 and 519:
Page 520 and 521:
Spain Enrique Bernal-Delgado, Sandr
Page 522 and 523:
Page 524 and 525:
Page 526 and 527:
Page 528 and 529:
Switzerland Alberto Holly and Phili
Page 530 and 531:
Page 532 and 533:
Tajikistan Ghafur Khodjamurodov Eco
Page 534 and 535:
Page 536 and 537:
Page 538 and 539:
Ukraine Valeria Lekhan and Mariia T
Page 540 and 541:
Page 542 and 543:
Page 544 and 545:
Page 546 and 547:
Page 548 and 549:
Page 550:
show all

Web-economic-crisis-health-systems-and-health-web

Create successful ePaper yourself

Delete template?

Save as template?