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Country profiles of health system responses to the crisis | Tajikistan 501 Changes to health service planning, purchasing and delivery Prices of medical goods • Reduction of VAT on pharmaceuticals from 18% to 5% has been discussed. Salaries and motivation of health sector workers • Increases in health sector worker salaries occurred from 2007 onwards: 30– 40% increase in 2012. Payment to providers • Approval of a government decree to introduce user fees for some consultative and diagnostic services with exemptions from payment for cetain categories of citizen (2008). Overhead costs: restructuring the Ministry of Health and purchasing agencies • Reduction of the number of staff in the Ministry of Health by 10% (2012). Provider infrastructure and capital investment • No responses reported. Priority setting or protocols to change access to treatments, coordination of care and patterns of use • No responses reported. Waiting times • No response reported Health promotion and prevention • A new Strategy for the Prevention and Control of Non-infectious Diseases and Trauma in the Republic of Tajikistan for 2013–2020 was approved by Government Decree 676, dated 3 December 2012.
Turkey Salih Mollahaliloglu and Mehtap Tatar Economic trends • Real per capita GDP in Turkey declined in 2009 by 4.0%, although growth surpassed pre-crisis levels the following year. The budget deficit in 2009 increased to 7% of GDP, as the government share of GDP increased. • The unemployment rate increased in 2009, but has since returned to European mean levels. • Health spending as a share of government expenditure remained stable between 2008 and 2011. Although OOP expenditure per capita decreased slightly in 2009 by 1.8%, public expenditure per capita increased throughout the 2008 to 2011 period (Turkey: Figs 1 and 2). Policy responses Changes to public funding for the health system • The budget of the Ministry of Health increased between 2008 and 2011. • Payment of SHI contributions for government employees and their dependants was transferred from the Ministry of Finance to the Social Security Institution (2010); expenditure for Green Card holders was transferred from the Ministry of Health to the Social Security Institution (2012). Population (entitlement) • No response reported. The benefits package • No response reported. User charges • Reimbursement rate for branded drugs without a generic option increased (from 32.5% to 41% of the ex-factory price) (2011). • Reduction of the reimbursement rate for drugs in the reference price system from 15% to 10% of the price of the cheapest drug (2011). • Reduction of the reimbursement rate for branded drugs with a generic option (from 28% to 20.5%) and for generics (from 28% to 20.5%) (2011). • Introduction of a new co-payment for prescriptions (TL 3 for up to three items and TL 1 for each additional item) (2012).
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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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xviii Economic crisis, health syste
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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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Cyprus Elisavet Constantinou and Ma
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Czech Republic Tomáš Roubal and J
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Estonia Triin Habicht and Mall Lein
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Finland Jan Klavus and Lauri Vuoren
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France Karine Chevreul, Karen Berg
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Germany Klaus-Dirk Henke and Wilm Q
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Iceland Sigrún Gunnarsdóttir and
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Ireland Anne Nolan and Steve Thomas
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Israel Bruce Rosen and Amir Shmueli
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Kazakhstan Ninel Kadyrova and Tata
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Latvia Uldis Mitenbergs and Maris T
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Malta Natasha Azzopardi Muscat Econ
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Montenegro Ratka Knežević Economi
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Page 486 and 487: Norway Anne Karin Lindahl and Jon M
Page 504 and 505: The Russian Federation Elena Potapc
Page 508 and 509: Serbia Vukasin Radulovic Economic t
Page 520 and 521: Spain Enrique Bernal-Delgado, Sandr
Page 528 and 529: Switzerland Alberto Holly and Phili
Page 532 and 533: Tajikistan Ghafur Khodjamurodov Eco
Page 538 and 539: Ukraine Valeria Lekhan and Mariia T
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