Hospital Sector Reform in Uzbekistan : A Policy Note
Since the mid-1990s, Uzbekistan has undergone reforms in the health sector focused on restructuring of primary health care in Uzbekistan as well as the establishment of an emergency medical care network. Reform and development initiatives in at secondary and tertiary care level have been limited to gradual downsizing of sub-national hospitals, with the exception of the emergency medical care network, and expansion of Republican specialized tertiary centers. Recent years have seen increases in out-of-pocket payments (both official and informal) for hospital and other health services, which now present a barrier to accessing health services and pharmaceuticals for some patients. The Ministry of Health (MOH) is implementing a program of development of new standards for diagnostic/curative services at each level of care that are intended to modernize practice and increase quality and efficiency. Twenty disease areas have been covered to date. Standards for equipment requirements at each level are also being defined. The Ministry now faces the challenge of developing a strategy to changing clinical and managerial practice in hospitals to bring them into line with the new standards. Uzbekistan has a large and fragmented network of hospitals and specialist clinics, characterized by multiple vertical programs and many single-specialty facilities. There is lack of clarity regarding the specific roles and linkages between the numerous hospitals and specialized care facilities. The Government has pursued a policy of increases in official user fees or "self-financing", alongside offsetting reductions in budget provision for non-salary operating costs in Republican hospitals and many Oblast hospitals in recent years. City and oblast hospitals have self-financing beds. User fees are projected to amount to an average of 18 percent of revenue in 2008 for oblast hospitals (compared to an average of 1.4 percent in 2000). Republican Specialist Centers (tertiary level hospitals) now obtain up to around 65 percent of revenue from user fees, and have a target of 80 percent. By contrast, rayon hospitals collect little user revenue (projected to be a little under 1percent in 2008, a level that is approximately unchanged since 2000). Budget funds for oblast hospital now cover little more than the costs of staff salaries and benefits, following budget reductions that offset increases in user fees.
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ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE |
| spellingShingle |
ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE Hawkins, Loraine Hospital Sector Reform in Uzbekistan : A Policy Note |
| description |
Since the mid-1990s, Uzbekistan has
undergone reforms in the health sector focused on
restructuring of primary health care in Uzbekistan as well
as the establishment of an emergency medical care network.
Reform and development initiatives in at secondary and
tertiary care level have been limited to gradual downsizing
of sub-national hospitals, with the exception of the
emergency medical care network, and expansion of Republican
specialized tertiary centers. Recent years have seen
increases in out-of-pocket payments (both official and
informal) for hospital and other health services, which now
present a barrier to accessing health services and
pharmaceuticals for some patients. The Ministry of Health
(MOH) is implementing a program of development of new
standards for diagnostic/curative services at each level of
care that are intended to modernize practice and increase
quality and efficiency. Twenty disease areas have been
covered to date. Standards for equipment requirements at
each level are also being defined. The Ministry now faces
the challenge of developing a strategy to changing clinical
and managerial practice in hospitals to bring them into line
with the new standards. Uzbekistan has a large and
fragmented network of hospitals and specialist clinics,
characterized by multiple vertical programs and many
single-specialty facilities. There is lack of clarity
regarding the specific roles and linkages between the
numerous hospitals and specialized care facilities. The
Government has pursued a policy of increases in official
user fees or "self-financing", alongside
offsetting reductions in budget provision for non-salary
operating costs in Republican hospitals and many Oblast
hospitals in recent years. City and oblast hospitals have
self-financing beds. User fees are projected to amount to an
average of 18 percent of revenue in 2008 for oblast
hospitals (compared to an average of 1.4 percent in 2000).
Republican Specialist Centers (tertiary level hospitals) now
obtain up to around 65 percent of revenue from user fees,
and have a target of 80 percent. By contrast, rayon
hospitals collect little user revenue (projected to be a
little under 1percent in 2008, a level that is approximately
unchanged since 2000). Budget funds for oblast hospital now
cover little more than the costs of staff salaries and
benefits, following budget reductions that offset increases
in user fees. |
| topic_facet |
ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE |
| author |
Hawkins, Loraine |
| author_facet |
Hawkins, Loraine |
| author_sort |
Hawkins, Loraine |
| title |
Hospital Sector Reform in Uzbekistan : A Policy Note |
| title_short |
Hospital Sector Reform in Uzbekistan : A Policy Note |
| title_full |
Hospital Sector Reform in Uzbekistan : A Policy Note |
| title_fullStr |
Hospital Sector Reform in Uzbekistan : A Policy Note |
| title_full_unstemmed |
Hospital Sector Reform in Uzbekistan : A Policy Note |
| title_sort |
hospital sector reform in uzbekistan : a policy note |
| publisher |
World Bank, Washington, DC |
| publishDate |
2012-01 |
| url |
http://documents.worldbank.org/curated/en/2012/01/16290772/hospital-sector-reform-uzbekistan-policy-note https://hdl.handle.net/10986/18367 |
| work_keys_str_mv |
AT hawkinsloraine hospitalsectorreforminuzbekistanapolicynote |
| _version_ |
1807159169136984064 |
| spelling |
dig-okr-10986183672024-08-08T15:11:02Z Hospital Sector Reform in Uzbekistan : A Policy Note Hawkins, Loraine ABILITY TO PAY AGED ALTERNATIVE MEDICINE AMBULANCE ANCILLARY SERVICES ARTHRITIS BABIES BLOOD SAFETY BLOOD TRANSFUSION CANCERS CAPACITY BUILDING CARDIOLOGY CASE MANAGEMENT CHILD HEALTH CHRONIC CONDITIONS CHRONIC DISEASE CHRONIC ILLNESS CITIES CLINICAL CARE CLINICAL MANAGEMENT CLINICAL PRACTICE CLINICAL PRACTICES CLINICAL SERVICES CLINICAL STAFF CLINICIANS CLINICS COMMUNICABLE DISEASE COMMUNICABLE DISEASES COMMUNITY HOSPITALS DEFICIENCY DISEASES DEPENDANTS DEVELOPMENT OF POLICIES DIABETES DIAGNOSIS DIAGNOSTIC TESTS DISABILITY DISEASE DISEASE MANAGEMENT DISEASE PREVENTION DISPENSARIES DISSEMINATION DOCTORS DRUG SUPPLY ECONOMIC IMPLICATIONS ELDERLY ELDERLY PEOPLE EMERGENCY CARE EMERGENCY MEDICAL CARE EMERGENCY SERVICES ENDOCRINOLOGY ESSENTIAL DRUGS EXPENDITURES FEASIBILITY STUDIES FEES FOR SERVICE FINANCIAL MANAGEMENT FINANCING POLICIES FREE CARE HEALTH AUTHORITIES HEALTH CARE COSTS HEALTH CARE OUTCOMES HEALTH CARE PROVIDERS HEALTH CARE SYSTEM HEALTH CARE SYSTEMS HEALTH EXPENDITURE HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INFORMATION HEALTH INFORMATION SYSTEMS HEALTH INSURANCE HEALTH MANAGEMENT HEALTH PLANNING HEALTH PROMOTION HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH SYSTEM HEALTH SYSTEMS HEALTHCARE HEALTHCARE PROVIDERS HEART DISEASE HIGH BLOOD PRESSURE HIV/AIDS HOSPITAL HOSPITAL ADMISSION HOSPITAL ADMISSIONS HOSPITAL AUTHORITIES HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CAPACITY HOSPITAL CARE HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL REGULATION HOSPITAL SERVICES HOSPITAL STAFF HOSPITAL SYSTEMS HOSPITAL TREATMENT HOSPITAL WARDS HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCE MANAGEMENT ILLNESS INCENTIVE SCHEMES INCOME INFECTION INFECTIOUS DISEASES INPATIENT ADMISSION INPATIENT ADMISSIONS INPATIENT CARE INSTITUTIONAL CAPACITY INSTITUTIONALIZATION INTEGRATION INTERVENTION IODINE DEFICIENCY LABORATORY TESTING LACK OF DEVELOPMENT LOCAL POPULATION MANAGEMENT OF PATIENTS MANAGEMENT SYSTEMS MATERNAL AND CHILD HEALTH MATERNITY HOSPITALS MEDICAL ASSISTANCE MEDICAL CENTER MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL STAFF MEDICINES MINISTRY OF HEALTH MODERNIZATION MORTALITY NATIONAL LEVEL NURSE NURSES NURSING NURSING HOMES NUTRITION OBSTETRIC CARE OBSTETRIC SERVICES OBSTETRICS OLDER PEOPLE OPHTHALMOLOGY PATIENT PATIENT CHOICE PATIENT SATISFACTION PATIENTS PEOPLE WITH DISABILITIES PHARMACEUTICALS PHARMACIES PHYSICIANS POPULATION GROUPS PRESCRIPTIONS PRESIDENTIAL DECREE PREVALENCE PRIMARY CARE PRIMARY HEALTH CARE PRIVATE PHARMACIES PROGRESS PROSTATE PROVIDER PAYMENT PSYCHIATRY PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITY CONTROL QUALITY IMPROVEMENT QUALITY OF SERVICES QUALITY SERVICES REAGENTS REFERRAL SYSTEM REFERRAL SYSTEMS REHABILITATION RESOURCE ALLOCATION RESOURCE USE RESPIRATORY DISEASE RISK OF DEATH ROOMS RURAL AREAS RURAL HOSPITALS SAFETY NET SERVICE DELIVERY SERVICE QUALITY SOCIAL ISSUES SPORTS MEDICINE SURGERY TB TECHNICAL ASSISTANCE TERTIARY LEVEL TREATMENT SERVICES TUBERCULOSIS UNIONS USER FEES VISITS VULNERABLE GROUPS WAR WASTE Since the mid-1990s, Uzbekistan has undergone reforms in the health sector focused on restructuring of primary health care in Uzbekistan as well as the establishment of an emergency medical care network. Reform and development initiatives in at secondary and tertiary care level have been limited to gradual downsizing of sub-national hospitals, with the exception of the emergency medical care network, and expansion of Republican specialized tertiary centers. Recent years have seen increases in out-of-pocket payments (both official and informal) for hospital and other health services, which now present a barrier to accessing health services and pharmaceuticals for some patients. The Ministry of Health (MOH) is implementing a program of development of new standards for diagnostic/curative services at each level of care that are intended to modernize practice and increase quality and efficiency. Twenty disease areas have been covered to date. Standards for equipment requirements at each level are also being defined. The Ministry now faces the challenge of developing a strategy to changing clinical and managerial practice in hospitals to bring them into line with the new standards. Uzbekistan has a large and fragmented network of hospitals and specialist clinics, characterized by multiple vertical programs and many single-specialty facilities. There is lack of clarity regarding the specific roles and linkages between the numerous hospitals and specialized care facilities. The Government has pursued a policy of increases in official user fees or "self-financing", alongside offsetting reductions in budget provision for non-salary operating costs in Republican hospitals and many Oblast hospitals in recent years. City and oblast hospitals have self-financing beds. User fees are projected to amount to an average of 18 percent of revenue in 2008 for oblast hospitals (compared to an average of 1.4 percent in 2000). Republican Specialist Centers (tertiary level hospitals) now obtain up to around 65 percent of revenue from user fees, and have a target of 80 percent. By contrast, rayon hospitals collect little user revenue (projected to be a little under 1percent in 2008, a level that is approximately unchanged since 2000). Budget funds for oblast hospital now cover little more than the costs of staff salaries and benefits, following budget reductions that offset increases in user fees. 2014-05-15T20:33:45Z 2014-05-15T20:33:45Z 2012-01 http://documents.worldbank.org/curated/en/2012/01/16290772/hospital-sector-reform-uzbekistan-policy-note https://hdl.handle.net/10986/18367 English en_US CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ application/pdf text/plain World Bank, Washington, DC |