MAIN TRENDS IN THE DEVELOPMENT OF HEALTHCARE SYSTEMS
DOI:
https://doi.org/10.34132/pard2025.29.06Keywords:
health care system, classification of health care systems, health care model, medical care, management.Abstract
The article analyzes the main models of national health care systems in different countries of the world. It is emphasized that health care models are different approaches to the organization and financing of health care systems, which can be divided into three main categories: state (budgetary), where the state fully finances and manages the system, either according to the budget model (with some variations) or according to the Beveridge model; social insurance (often called "continental"), where financing is carried out through deductions from salaries and funds, and management is carried out through social insurance bodies; and market (private), where private clinics prevail and services are paid directly by patients or through private insurance. The peculiarities of their formation and functioning are shown; the functioning of the model is determined by the principles of management, financing, organization of medical care and its accessibility to the population. The application of health care system models in China, Germany, France, Austria, Switzerland, the USA, Scandinavian countries, Great Britain, Ireland and others is considered. Fundamental differences between the systems are identified. Disadvantages and advantages in the organization of medical care for the population are noted, taking into account the complex system of economic relationships of health care financing and the role of the state in management. The advantages of the state approach are universal access and social protection, and the disadvantages are potential bureaucratization and inefficiency. The private model offers a high level of service and innovation, but suffers from accessibility for the poor and uneven quality. Insurance models combine public and private financing, striving for a balance between accessibility and efficiency, and mixed systems may have their own unique strengths and weaknesses. Modern classifications of health care systems and a rating of the effectiveness of national health care systems are presented. It is emphasized that modern health care models differ in the structure of financing (budgetary, insurance, private), the organization of medical care (national, pluralistic) and the approach to health (biomedical, biopsychosocial). Their development is aimed at increasing the accessibility and quality of medical care, strengthening the primary care, introducing new technologies and efficient use of resources to preserve and improve the health of the population.
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