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

338 Economic crisis, health systems and health in Europe: country experience
Changes to health service planning, purchasing and delivery
Prices of medical goods
• The Ministry of Health signed a memorandum on cost-containment
with leading producers and distributors (2011) and established a
Pharmaceutical Department (2012); responsibility for regulating drug
prices was moved from the Ministry of Economy to the Ministry of
Health (2012).
• Adopted a policy of import substitution aimed at increasing the share
of domestic products and of allocation of financial resources to priority
needs (2010–2012).
Salaries and motivation of health sector workers
• Eliminated ineffective positions; introduced population-to-staff ratios in
outpatient settings and “doctor's assistant” positions in outpatient primary
care settings (since 2009).
• Salary increases of 25% for all physicians working in public (budgetary)
institutions and 10% increases for young health care workers (2010).
• Further salary increases for health professionals (2011) and nurses (2012).
• Launched a pilot project aimed at improvement of planning, distribution and
financing of health care institutions' expenditure in two regions of the country.
As part of the project, quality indicators measuring prevention, management
of chronic diseases, replacement of secondary (specialized) medical care and
organizational issues were used to determine physicians' bonuses in outpatient
and inpatient health care (2013).
Payment to providers
• No response reported.
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• Reduction of expenditure on fuel and energy resources, transport,
business trips and communication services (July 2011).
• Merged the “parallel” budgets of Belarusian Railway, Medical Service of
Civil Aviation, Ministry of Education with the budget of the Ministry
of Health in order to consolidate finance for health care and rationalize
financing (2011–2012).
Provider infrastructure and capital investment
• Reduction of and/or deferred investment in capital assets (infrastructure
and equipment), expensive facilities and construction. However,
information technology systems are being introduced in many regions