World Bank2013-02-112013-02-112011-05-11https://hdl.handle.net/10986/12290This Functional Review was carried by a Bank team upon request by the Government of Romania. As a starting point, it shows that: (i) health outcomes in Romania lag behind those of the EU; (ii) users are not satisfied with its lack of responsiveness - long lines, informal payments, discourteous handling of patients, poor cleanliness, lack of maintenance, and breach of safety measures; (iii) the poor and other vulnerable groups (for example Roma communities) suffer from a significant lack of access to services; and (iv) the fiscal contraction of 2008-2010 exposed the weakness of financial controls in the health sector. The Review examines four health functions in depth: service delivery, financing, stewardship and resources (including pharmaceuticals). Based on our findings, we present recommendations categorized by the three set of challenges that the sector is facing: (i) improving governance and management; (ii) streamlining the health service network and re-launching quality control systems; and (iii) increasing preventive services and equity. For any expansion of the sector to be sustainable, a number of pre-requisites will need to be in place, including a private sector development strategy, stronger fiscal controls, a system of health technology assessment, and stronger management in key agencies.en-USCC BY 3.0 IGOACCESS TO HEALTH CAREACCESS TO HEALTH SERVICESACCESS TO SERVICESAGE GROUPSAGE STRUCTUREAGINGAMBULATORY CAREAMBULATORY SERVICESBUDGET CEILINGBUDGET INCREASEBURDEN OF DISEASECAPITATIONCARDIOVASCULAR DISEASESCARE PURCHASERSCENTER FOR HEALTHCERVICAL CANCERCHILD HEALTHCHRONIC CONDITIONSCHRONIC DISEASECITIZENSCLEANLINESSCLINICAL GUIDELINESCLINICSCOMMUNICABLE DISEASESCONTRACTUAL RELATIONSCONTRACTUAL RELATIONSHIPSCONTRIBUTION RATECOST STRUCTURECOST-EFFECTIVENESSDAY CAREDEATH RATEDEATHSDEBTDECISION MAKINGDELIVERY OF HEALTH SERVICESDEMOCRACYDIABETESDOCTORSECONOMIC GROWTHEMERGENCIESEQUITY IN ACCESSEXPENDITURESFAMILIESFEES FOR SERVICEFINANCIAL BARRIERSFINANCIAL CONTROLSFINANCIAL INCENTIVESFINANCIAL INFORMATIONFINANCIAL MANAGEMENTFINANCIAL PROTECTIONFINANCIAL RESOURCESFINANCIAL RISKFINANCING OF HEALTH CAREGENERAL PRACTITIONERSGROSS DOMESTIC PRODUCTGROSS NATIONAL PRODUCTHEALTH CARE INSTITUTIONSHEALTH CARE NEEDSHEALTH CARE PROVIDERHEALTH CARE PROVIDERSHEALTH CARE SYSTEMHEALTH DATAHEALTH EXPENDITUREHEALTH EXPENDITURESHEALTH FACILITIESHEALTH FINANCINGHEALTH FOR ALLHEALTH INDICATORSHEALTH INSURANCEHEALTH INSURANCE CONTRIBUTIONSHEALTH INSURANCE FUNDSHEALTH INSURANCE SYSTEMHEALTH MANAGEMENTHEALTH MINISTRIESHEALTH NEEDSHEALTH ORGANIZATIONHEALTH OUTCOMESHEALTH POLICIESHEALTH POLICYHEALTH PROFESSIONALSHEALTH PROGRAMSHEALTH PROMOTIONHEALTH PROVIDERSHEALTH PURCHASERHEALTH REFORMHEALTH REFORMSHEALTH SECTORHEALTH SERVICEHEALTH SERVICE DELIVERYHEALTH SERVICESHEALTH SPENDINGHEALTH STATUSHEALTH SYSTEMHEALTH SYSTEM PERFORMANCEHEALTH SYSTEMSHEALTH WORKERSHEALTH WORKFORCEHIVHIV/AIDSHOLISTIC APPROACHHOME CAREHOSPITALHOSPITAL ACCREDITATIONHOSPITAL ADMINISTRATORSHOSPITAL ADMISSIONSHOSPITAL BEDSHOSPITAL CAREHOSPITAL PATIENTSHOSPITAL SECTORHOSPITAL SERVICESHOSPITALIZATIONHOSPITALSHRHUMAN IMMUNODEFICIENCY VIRUSHUMAN RESOURCE MANAGEMENTHUMAN RESOURCESHYGIENEHYPERTENSIONILLNESSIMMUNIZATIONIMMUNODEFICIENCYINCENTIVES FOR PROVIDERSINCOMEINCOME COUNTRIESINCOME DISTRIBUTIONINCOME GROUPSINFANT MORTALITYINFANT MORTALITY RATESINFECTIOUS DISEASESINFORMAL PAYMENTSINFORMAL SECTORINFORMATION SYSTEMINFORMATION SYSTEMSINTEGRATIONLIFE EXPECTANCYLIFE EXPECTANCY AT BIRTHLIVE BIRTHSLOCAL GOVERNMENTSLOW INCOMEMALARIAMANAGEMENT OF HUMAN RESOURCES IN HEALTHMATERNAL DEATHSMATERNAL MORTALITYMEDICAL CAREMEDICAL DOCTORSMEDICAL EQUIPMENTMEDICAL SERVICESMEDICAL SPECIALTIESMEDICAL TECHNOLOGYMEDICINESMIGRATIONMINISTRY OF HEALTHMORBIDITYMORTALITYNATIONAL HEALTHNATIONAL HEALTH INSURANCENATIONAL HEALTH INSURANCE FUNDNATIONAL HEALTH POLICIESNON-GOVERNMENTAL ORGANIZATIONSNURSENURSINGNURSING HOMESNUTRITIONOLD SYSTEMOUTPATIENT SERVICESPALLIATIVE CAREPATIENTPATIENT RIGHTSPATIENTSPHARMACEUTICAL EXPENDITUREPHARMACIESPHARMACYPHYSICAL ACTIVITYPHYSICIANPHYSICIANSPLASTIC SURGERYPOLICY DOCUMENTPOLICY FORMULATIONPRESCRIPTION DRUGSPRIMARY CAREPRIMARY CARE DOCTORSPRIMARY HEALTH CAREPRIMARY HEALTH CARE SERVICESPRIVATE FINANCINGPRIVATE INSURANCEPRIVATE SECTORPRIVATE SERVICESPROBABILITYPROFESSIONAL ASSOCIATIONSPROGRESSPROVISION OF SERVICESPUBLIC ADMINISTRATIONPUBLIC HEALTHPUBLIC HOSPITALSPUBLIC POLICIESPUBLIC SECTORPUBLIC SPENDINGQUALITY CONTROLQUALITY OF LIFERADIOLOGYREHABILITATIONRESPECTRISK FACTORSSAFETY MEASURESSCREENINGSERVICE PROVISIONSMOKINGSOCIAL HEALTH INSURANCESURGERYTB CONTROLTUBERCULOSISUSE OF HEALTH SERVICESVACCINATIONVACCINATIONSVULNERABLE GROUPSWORKERSWORLD HEALTH ORGANIZATIONWorld Bank10.1596/12290