Ekonomske krize kao poticaj promjena u zdravstvenom sustavu – povijesna perspektiva s osvrtom na pandemiju COVID-19

Abstract

Economic crises throughout history have often given an impetus for health and social reforms leading to the introduction of general healthcare systems and social equality in a large number of countries. The aim of this paper is to present the major economic crises and their effect on healthcare and social system chronologically. Bismarck’s and Beveridge’s model, the two most prominent healthcare models, which emerged primarily as a response to major economic crises, constitute the basis for the functioning of most health care systems in the world. An overview of historical events and experiences may be valuable in predicting future developments and potential effects of the crisis on healthcare systems and health in general. An analysis of past crises as well as current health and economic crisis caused by the COVID-19 pandemic and their impact on the healthcare system can facilitate the comprehension of the mechanisms of action and consequences of economic recession. It may also help identify guidelines and changes that might reduce the potential damage caused by future crises. The historical examples presented show that a crisis could trigger changes, which, in theiressence, are not necessarily negative. The response of society as a whole determines the direction of these changes, and it is up to society to transform the negative circumstances brought about by the recession into activities that contribute to general well-being and progress.

What Drives Healthcare Expenditure Growth? Evidence from Central and Eastern European Economies

“…The economic determinants of healthcare become particularly evident in times of financial crisis, having a significant impact on the planning of healthcare expenditure and the healthcare system itself. In times of recession, it is crucially important to protect underprivileged and vulnerable groups (Kaštelan et al, 2020;Kaštelan et al, 2020a). Currently, out-of-pocket payments constitute a major source of healthcare financing, with patients being confronted with a range of payment obligations for the use of healthcare services.…”

“…However, the long-term repercussions of the pandemic in terms of changing the functioning of health systems and priorities in national economies are still difficult to envisage (Kaštelan et al, 2020). Even so, this crisis could serve as a reminder that investing in the health sector is very important.…”

The need for a multi-level drug targeting strategy to curb the COVID-19 pandemic

“…In addition to the economic and health system deterioration worldwide, there are many other adverse effects which may limit the success of the present operated policies for curbing the COVID-19 pandemic (Fig. 1) [26]. The limitations of the present policies include the low availability of vaccines in many countries and also the need for new vaccines to control the emergence of new SARS-CoV-2 mutations and variants, as well as suspected more virulent variants in the future, which appear to originate from countries with lower rates of vaccination.…”

“…Other side effects of the prolonged enclosures are the psychological, educational, socioeconomic implications (Fig. 1) [25][26][27][28][29].…”

Primary care responses to the COVID-19 pandemic

“…Primary care training has likely suffered due to early restrictions on personal protective equipment, quarantine of health care workers and reduced morale amongst practicing physicians and nurses (4)(5)(6). Rapid adoption of telehealth, and outreach to existing patient populations has created a demand for new methods of care delivery (7) and reimbursement, while concurrently raising a multitude of questions about effectiveness and financial stability (8).…”