The reform of the Romanian health care system : a comparative study of regional health directorates during 1990’s

• This paper analyses the development of the Romanian health care system at regional health directorate level since the transition in 1989. First, we outline the development of the Romanian economy and especially the reform of the health care system. Basically, the Ministry of Health coordinates the health care system through 42 regional health directorates and health care is delivered free of charge to all inhabitants in Romania, with very few exceptions (some small and private clinics). Second, we analyze the effects of the reforms in health care sector during 1990’s by exploring the variations of health care expenditures at regional health directorate level, controlling for differences in expenditures, which can be grouped into demographic and health care organization characteristics. We use health data from databases at regional health directorate level of the National Institute of Statistics. The differences between regional health directorates were analyzed by a stochastic frontier panel cost function. The results indicate significant differences in efficiency across regions, and especially between urban and rural areas. This can mainly be explained by (i) an input-oriented funding system related to the number of inhabitants, wherein the parliament set minimum levels of health service budget for each district until 1996, and (ii) the primary health care reform with a new way of financing health care in addition to the introduction of contracts between district health directorates and general practitioners (as individuals or groups), which shifted the responsibility from hospitals to the district health directorates,  and this was only piloted in 8 regional health directorates (out of 41) in 1994. 

Ämnesord

SAMHÄLLSVETENSKAP  -- Ekonomi och näringsliv -- Nationalekonomi (hsv//swe)

SOCIAL SCIENCES  -- Economics and Business -- Economics (hsv//eng)

Nyckelord

reform

health care system

comparative study

regional health directorates

Romania

Economics

Nationalekonomi

Publikations- och innehållstyp

ref (ämneskategori)

kon (ämneskategori)