Primary care behind the former "Iron Curtain": changes and development of primary healthcare provision in the Eastern part of the European Union.

Autor:	Semánová C; Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary., Rurik SE; Independent Macroeconomic adviser, Budapest, Hungary., Dózsa C; Faculty of Health Care, University of Miskolc, Miskolc, Hungary., Jancsó Z; Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary., Kolozsvári LR; Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary., Nánási A; Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary., Pfeiferová M; Department of General Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic., Rurik I; Department of Family and Occupational Medicine, University of Debrecen, Debrecen, Hungary.
Jazyk:	angličtina
Zdroj:	Primary health care research & development [Prim Health Care Res Dev] 2019 Sep 09; Vol. 20, pp. e121. Date of Electronic Publication: 2019 Sep 09.
DOI:	10.1017/S1463423619000410
Abstrakt:	Background: The Alma-Ata Declaration was a big step in the development of primary care, defining the main tasks and populations' expectation. Celebrating the 40th year's anniversary is a good opportunity to make an analysis. Development of primary care was not parallel in the Eastern and Western part of Europe. Aim: To provide an overview on the societal and economic situation, structural and financial changes of healthcare systems in the former 'Soviet bloc' countries, to present an analysis of the primary healthcare (PHC) provision and to find relationships between economic development and epidemiological changes of the respective countries. Method: Epidemiological data, healthcare expenditures and structure, and financing schemes were compared; systematic literature search was performed. Results: Visible improvements in population health, in the national economic condition, structural changes in healthcare and more focus to primary care were experienced everywhere. Higher life expectancies with high inter-country variation were observed in the former 'Soviet bloc' countries, although it could not be clearly linked to the development of healthcare system. PHC provision improved while structural changes were rarely initiated, often only as a project or model initiation. Single-handed practices are yet predominant. The gate-keeping system is usually weak; there were no effective initiatives to improve the education of nurses and to widen their competences. Migrations of workforce to Western countries become a real threat for the Central-East European countries. Conclusion: Lack of coordination between practices and interdisciplinary cooperation were recognized as the main barriers for further improvement in the structure.
Databáze:	MEDLINE
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