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Country profiles of health system responses to the crisis | Iceland 403 Changes to health service planning, purchasing and delivery Prices of medical goods • Introduction of new prescribing rules (generics prescribed before trying more expensive alternatives); if rules are not followed, patients must pay the full cost of the drug (2009). Salaries and motivation of health sector workers • Cuts to overtime rates and night shifts, and longer shifts with fewer staff implemented to reduce health worker salary bills in individual health care organizations (2009). • Staff cuts of approximately 10% at the National University Hospital (2007–2010). • Hiring of young professionals to train as family doctors (since 2010). Payment to providers • No response reported. Overhead costs: restructuring the Ministry of Health and purchasing agencies • Ministry of Health and Ministry of Social Affairs merged to reduce administrative costs (2008). • Directorate of Health and the Public Health Institute merged (2011). Provider infrastructure and capital investment • Decision to build a smaller and less-expensive new University Hospital than had been originally planned before the crisis (2009). In 2012, Reykjavik City made a decision to facilitate the continuing work on the new hospital design and preparation to start building in 2014. • Primary health centres merged to reduce, for example, the number of rural health centres from 20 to 12 between 2007 and 2011. • Introduction of a merger of small hospitals and primary health care centres in rural areas (2010 and 2011), which was minimized following strong objections from local citizens and politicians. • A relatively small hospital in the capital area was closed and its services moved to other hospitals in the area (2011). Priority setting or protocols to change access to treatments, coordination of care and patterns of use • No response reported. Waiting times • No response reported.
404 Economic crisis, health systems and health in Europe: country experience Health promotion and prevention • A range of national and municipal programmes promoting the well-being of young people and families (since 2008).
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Economic crisis, health systems and
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The European Observatory on Health
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Keywords: DELIVERY OF HEALTH CARE E
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vi Economic crisis, health systems
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viii Economic crisis, health system
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List of abbreviations ACS Health in
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List of tables and figures Tables P
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xiv Economic crisis, health systems
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xvi Economic crisis, health systems
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xviii Economic crisis, health syste
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xx Economic crisis, health systems
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xxii Economic crisis, health system
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xxvi Economic crisis, health system
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Acknowledgements This book represen
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Preface This book maps health polic
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Part I Country case studies
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4 Economic crisis, health systems a
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10 Economic crisis, health systems
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Chapter 4 The impact of the crisis
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Chapter 4 | The impact of the crisi
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Albania Genc Burazeri and Enver Ros
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Country profiles of health system r
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Austria Thomas Czypionka and Maria
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Azerbaijan Fuad Ibrahimov Economic
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Bulgaria Antoniya Dimova and Mina P
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Page 390 and 391: Cyprus Elisavet Constantinou and Ma
Page 394 and 395: Czech Republic Tomáš Roubal and J
Page 404 and 405: Estonia Triin Habicht and Mall Lein
Page 408 and 409: Finland Jan Klavus and Lauri Vuoren
Page 412 and 413: France Karine Chevreul, Karen Berg
Page 420 and 421: Germany Klaus-Dirk Henke and Wilm Q
Page 434 and 435: Iceland Sigrún Gunnarsdóttir and
Page 438 and 439: Ireland Anne Nolan and Steve Thomas
Page 444 and 445: Israel Bruce Rosen and Amir Shmueli
Page 452 and 453: Kazakhstan Ninel Kadyrova and Tata
Page 458 and 459: Latvia Uldis Mitenbergs and Maris T
Page 470 and 471: Malta Natasha Azzopardi Muscat Econ
Page 478 and 479: Montenegro Ratka Knežević Economi
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Norway Anne Karin Lindahl and Jon M
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The Russian Federation Elena Potapc
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Serbia Vukasin Radulovic Economic t
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Spain Enrique Bernal-Delgado, Sandr
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Switzerland Alberto Holly and Phili
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Tajikistan Ghafur Khodjamurodov Eco
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Ukraine Valeria Lekhan and Mariia T
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