Reducing inequities in healthcare: a priority for European policies and measures

Abstract

Goals: This study is intended to highlight the importance of health determinants and equity in healthcare in an international and European context, to provide an overview on health inequities and on how they correlate with the political decisions for the ethical allocation of resources in the healthcare system from Romania. Methodology: The distribution of health socio-economic determinants was assessed by using data from two studies conducted by the National Institute of Statistics. Data for 2009 processed by NSPHHM were used in order to analyze the indicators regarding the main aspects of hospital activity and admitted morbidities. Concerning the analysis of the main demographic aspects and the trend of health expenses at national and/or regional level, the utilized data came from NCOPIISH 2 (for 2007), EUROSTAT (statistical database 2009) and from WHO’s National Health Account database. Absolute values were also used and rates for assessing inequalities and inequities in resource allocation in healthcare system (medical doctors, nurses, beds, high-tech medical equipment) were calculated per development regions. Outcomes: The demand of healthcare services exceeds the ability to finance them from public funds (state budgets for health and social security funds). The share of out-of-pocket payments made by households in the total healthcare expenses is considerable (over 20%) This situation exposes households to a catastrophic risk (over 40% of the overall costs of a household). In the same time, decision makers face difficulties in a better understanding of the consumption causes in the healthcare system in order to create the premises of a better allocation of available resources. Inequalities between development regions are induced by: inequalities in health status and structure of risk factors to which the population from a certain region is exposed; inequalities in the need for healthcare services; inequalities in the service offer; inequality in providing service continuity; inequalities in the capacity of local authorities (DHA, DHIH, town-halls and county councils) to make organizational changes.