Publication:
Hospital Sector Reform in Uzbekistan : A Policy Note

dc.contributor.authorHawkins, Loraine
dc.date.accessioned2014-05-15T20:33:45Z
dc.date.available2014-05-15T20:33:45Z
dc.date.issued2012-01
dc.description.abstractSince 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.en
dc.identifierhttp://documents.worldbank.org/curated/en/2012/01/16290772/hospital-sector-reform-uzbekistan-policy-note
dc.identifier.urihttps://hdl.handle.net/10986/18367
dc.languageEnglish
dc.language.isoen_US
dc.publisherWorld Bank, Washington, DC
dc.rightsCC BY 3.0 IGO
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectABILITY TO PAY
dc.subjectAGED
dc.subjectALTERNATIVE MEDICINE
dc.subjectAMBULANCE
dc.subjectANCILLARY SERVICES
dc.subjectARTHRITIS
dc.subjectBABIES
dc.subjectBLOOD SAFETY
dc.subjectBLOOD TRANSFUSION
dc.subjectCANCERS
dc.subjectCAPACITY BUILDING
dc.subjectCARDIOLOGY
dc.subjectCASE MANAGEMENT
dc.subjectCHILD HEALTH
dc.subjectCHRONIC CONDITIONS
dc.subjectCHRONIC DISEASE
dc.subjectCHRONIC ILLNESS
dc.subjectCITIES
dc.subjectCLINICAL CARE
dc.subjectCLINICAL MANAGEMENT
dc.subjectCLINICAL PRACTICE
dc.subjectCLINICAL PRACTICES
dc.subjectCLINICAL SERVICES
dc.subjectCLINICAL STAFF
dc.subjectCLINICIANS
dc.subjectCLINICS
dc.subjectCOMMUNICABLE DISEASE
dc.subjectCOMMUNICABLE DISEASES
dc.subjectCOMMUNITY HOSPITALS
dc.subjectDEFICIENCY DISEASES
dc.subjectDEPENDANTS
dc.subjectDEVELOPMENT OF POLICIES
dc.subjectDIABETES
dc.subjectDIAGNOSIS
dc.subjectDIAGNOSTIC TESTS
dc.subjectDISABILITY
dc.subjectDISEASE
dc.subjectDISEASE MANAGEMENT
dc.subjectDISEASE PREVENTION
dc.subjectDISPENSARIES
dc.subjectDISSEMINATION
dc.subjectDOCTORS
dc.subjectDRUG SUPPLY
dc.subjectECONOMIC IMPLICATIONS
dc.subjectELDERLY
dc.subjectELDERLY PEOPLE
dc.subjectEMERGENCY CARE
dc.subjectEMERGENCY MEDICAL CARE
dc.subjectEMERGENCY SERVICES
dc.subjectENDOCRINOLOGY
dc.subjectESSENTIAL DRUGS
dc.subjectEXPENDITURES
dc.subjectFEASIBILITY STUDIES
dc.subjectFEES FOR SERVICE
dc.subjectFINANCIAL MANAGEMENT
dc.subjectFINANCING POLICIES
dc.subjectFREE CARE
dc.subjectHEALTH AUTHORITIES
dc.subjectHEALTH CARE COSTS
dc.subjectHEALTH CARE OUTCOMES
dc.subjectHEALTH CARE PROVIDERS
dc.subjectHEALTH CARE SYSTEM
dc.subjectHEALTH CARE SYSTEMS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INFORMATION
dc.subjectHEALTH INFORMATION SYSTEMS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH MANAGEMENT
dc.subjectHEALTH PLANNING
dc.subjectHEALTH PROMOTION
dc.subjectHEALTH REFORM
dc.subjectHEALTH REFORMS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTHCARE
dc.subjectHEALTHCARE PROVIDERS
dc.subjectHEART DISEASE
dc.subjectHIGH BLOOD PRESSURE
dc.subjectHIV/AIDS
dc.subjectHOSPITAL
dc.subjectHOSPITAL ADMISSION
dc.subjectHOSPITAL ADMISSIONS
dc.subjectHOSPITAL AUTHORITIES
dc.subjectHOSPITAL AUTONOMY
dc.subjectHOSPITAL BEDS
dc.subjectHOSPITAL CAPACITY
dc.subjectHOSPITAL CARE
dc.subjectHOSPITAL MANAGEMENT
dc.subjectHOSPITAL MANAGERS
dc.subjectHOSPITAL REGULATION
dc.subjectHOSPITAL SERVICES
dc.subjectHOSPITAL STAFF
dc.subjectHOSPITAL SYSTEMS
dc.subjectHOSPITAL TREATMENT
dc.subjectHOSPITAL WARDS
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCE MANAGEMENT
dc.subjectILLNESS
dc.subjectINCENTIVE SCHEMES
dc.subjectINCOME
dc.subjectINFECTION
dc.subjectINFECTIOUS DISEASES
dc.subjectINPATIENT ADMISSION
dc.subjectINPATIENT ADMISSIONS
dc.subjectINPATIENT CARE
dc.subjectINSTITUTIONAL CAPACITY
dc.subjectINSTITUTIONALIZATION
dc.subjectINTEGRATION
dc.subjectINTERVENTION
dc.subjectIODINE DEFICIENCY
dc.subjectLABORATORY TESTING
dc.subjectLACK OF DEVELOPMENT
dc.subjectLOCAL POPULATION
dc.subjectMANAGEMENT OF PATIENTS
dc.subjectMANAGEMENT SYSTEMS
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMATERNITY HOSPITALS
dc.subjectMEDICAL ASSISTANCE
dc.subjectMEDICAL CENTER
dc.subjectMEDICAL EQUIPMENT
dc.subjectMEDICAL PRACTICE
dc.subjectMEDICAL STAFF
dc.subjectMEDICINES
dc.subjectMINISTRY OF HEALTH
dc.subjectMODERNIZATION
dc.subjectMORTALITY
dc.subjectNATIONAL LEVEL
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNURSING
dc.subjectNURSING HOMES
dc.subjectNUTRITION
dc.subjectOBSTETRIC CARE
dc.subjectOBSTETRIC SERVICES
dc.subjectOBSTETRICS
dc.subjectOLDER PEOPLE
dc.subjectOPHTHALMOLOGY
dc.subjectPATIENT
dc.subjectPATIENT CHOICE
dc.subjectPATIENT SATISFACTION
dc.subjectPATIENTS
dc.subjectPEOPLE WITH DISABILITIES
dc.subjectPHARMACEUTICALS
dc.subjectPHARMACIES
dc.subjectPHYSICIANS
dc.subjectPOPULATION GROUPS
dc.subjectPRESCRIPTIONS
dc.subjectPRESIDENTIAL DECREE
dc.subjectPREVALENCE
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIVATE PHARMACIES
dc.subjectPROGRESS
dc.subjectPROSTATE
dc.subjectPROVIDER PAYMENT
dc.subjectPSYCHIATRY
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC SERVICES
dc.subjectPURCHASING POWER
dc.subjectQUALITY CONTROL
dc.subjectQUALITY IMPROVEMENT
dc.subjectQUALITY OF SERVICES
dc.subjectQUALITY SERVICES
dc.subjectREAGENTS
dc.subjectREFERRAL SYSTEM
dc.subjectREFERRAL SYSTEMS
dc.subjectREHABILITATION
dc.subjectRESOURCE ALLOCATION
dc.subjectRESOURCE USE
dc.subjectRESPIRATORY DISEASE
dc.subjectRISK OF DEATH
dc.subjectROOMS
dc.subjectRURAL AREAS
dc.subjectRURAL HOSPITALS
dc.subjectSAFETY NET
dc.subjectSERVICE DELIVERY
dc.subjectSERVICE QUALITY
dc.subjectSOCIAL ISSUES
dc.subjectSPORTS MEDICINE
dc.subjectSURGERY
dc.subjectTB
dc.subjectTECHNICAL ASSISTANCE
dc.subjectTERTIARY LEVEL
dc.subjectTREATMENT SERVICES
dc.subjectTUBERCULOSIS
dc.subjectUNIONS
dc.subjectUSER FEES
dc.subjectVISITS
dc.subjectVULNERABLE GROUPS
dc.subjectWAR
dc.subjectWASTE
dc.titleHospital Sector Reform in Uzbekistan : A Policy Noteen
dspace.entity.typePublication
okr.date.disclosure2012-05-30
okr.doctypeEconomic & Sector Work::Policy Note
okr.doctypeEconomic & Sector Work
okr.docurlhttp://documents.worldbank.org/curated/en/2012/01/16290772/hospital-sector-reform-uzbekistan-policy-note
okr.globalpracticeHealth, Nutrition, and Population
okr.globalpracticeGovernance
okr.globalpracticeHealth, Nutrition, and Population
okr.identifier.externaldocumentum000333038_20120530233604
okr.identifier.internaldocumentum16290772
okr.identifier.report69137
okr.language.supporteden
okr.pdfurlhttp://www-wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2012/05/30/000333038_20120530233604/Rendered/PDF/691370ESW0whit0hospital0policy0note.pdfen
okr.region.administrativeEurope and Central Asia
okr.region.countryUzbekistan
okr.sectorHealth and other social services :: Health
okr.themeHuman development :: Health system performance
okr.topicLaw and Development::Health Law
okr.topicHealth, Nutrition and Population::Population Policies
okr.topicHealth Monitoring and Evaluation
okr.topicHealth Systems Development and Reform
okr.topicDisease Control and Prevention
okr.topicHealth
okr.topicNutrition and Population
okr.unitHuman Development Sector Unit (ECSHD)
okr.volume1 of 1
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