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 49 Table 2.1 Demographic and economic indicators in Estonia, 2000–2012 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 Total population 1,379.3 1,373.5 1,367.6 1,361.6 1,356.2 1,351.2 1,346.0 1,342.0 1,342.3 1,340.3 1,338.5 1,336.9 1,335.0 (in thousands) a People aged 65 and over 15.0 15.2 15.6 16.0 16.4 16.7 17.0 17.3 17.4 17.4 17.4 17.5 17.8 (% total population) a GDP per capita 5,800 6,200 6,600 7,100 7,600 8,300 9,200 9,900 9,500 8,100 8,400 9,100 9,400 (e) a Real GDP growth – – – 7.8 6.3 8.9 10.1 7.5 –4.2 –14.1 3.3 8.3 3.2 (%) a Government deficit – – 0.3 1.7 1.6 1.6 2.5 2.4 –3.0 –2.0 0.2 1.1 –0.2 (% GDP) b Government consolidated 5.1 4.8 5.7 5.6 5.0 4.6 4.4 3.7 4.5 7.1 6.7 6.1 9.8 (% GDP) b gross debt Total unemployment 13.6 12.6 10.3 10.0 9.7 7.9 5.9 4.8 5.5 13.8 16.9 12.5 10.2 (% total labour force) a Long-term unemployment 6.2 6.1 5.4 4.6 5.1 4.2 2.8 2.3 1.7 3.8 7.7 7.1 – (% active population) a Note: Population figures may differ slightly from national sources. Sources: a OECD, 2014; b Eurostat, 2013.
50 Economic crisis, health systems and health in Europe: country experience 1.3 Broader consequences As a result of these measures, Estonia was able to keep public sector debt at around 7% of GDP in 2009, which was one of the lowest rates in Europe. The overall public sector budget deficit was 2% of GDP in 2009 followed by a surplus of 0.2% in 2010 and 1.1% in 2011. The government reserves were 11.6% of GDP in 2009 and 12% of GDP in 2010. 2. Health system pressures prior to the crisis The health system was relatively well prepared for an economic shock of this magnitude, which was a significant contraction but of short duration. The EHIF accumulated sufficient reserves during the previous years of rapid growth – in fact far more than was legally required – signalling its careful expansion policy. Because significant restructuring in service delivery and payment reforms took place long before the crisis, major inefficiencies in the health system had already been dealt with. Although EHIF spending increased during the years of growth, these increases were not as great as increases in other parts of the public sector and, in any case, were less than increases in revenue. The EHIF focused on enhancing cost–effectiveness in pricing, contracting and the benefits package. Financial protection has also improved since 2009 through policies to encourage rational prescribing, generic substitution and limitation of the financial burden of user charges on patients (see section 3.2). In addition, in the years immediately preceding the crisis, the health system had invested in analysing a range of key issues, including financial sustainability. As a result of all these measures, the health system was relatively well placed to manage a short-term crisis. 3. Health system responses to the crisis The main change affecting the health sector was the restructuring of health expenditure in line with reduced health budgets while simultaneously trying to have the least possible effect on the financing of core health care services. At the beginning of the economic crisis, the health sector, and the national health insurance system in particular, was in a better position compared with other parts of the public sector as the EHIF had accumulated substantial reserves through rapid revenue growth during the early 2000s. In addition, the health sector had more leeway in responding to the crisis as most of the high-impact changes introduced during the crisis (mainly measures to control expenditure growth) were already in the pipeline before the crisis. 3.1 Changes to public funding for the health system One of the major fiscal responses to the economic crisis was to cut public expenditure to ensure a stable, medium-term fiscal position and to support
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 43 and 44: 10 Economic crisis, health systems
Page 81: 48 Economic crisis, health systems
Page 133 and 134:
100 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 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
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:
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?