This paper aims to: (1) provide a brief overview of hospital sector characteristics in 11 Central and Eastern European countries (Bulgaria, Czech Republic, Estonia, Croatia, Latvia, Lithuania, Hungary, Poland, Romania, Slovakia, Slovenia); (2) compare recent (2008 - 2019) hospital reforms in these countries; and (3) identify common trends, success factors and challenges for reforms. Methods applied involved five stages: (1) a theoretical framework of hospital sector reforms was developed; (2) basic quantitative data characterizing hospital sectors were compared; (3) a scoping review was performed to identify an initial list of reforms per country; (4) the list was sent to national researchers who described the top three reforms based on a standardized questionnaire; (5) received questionnaires were analysed and validated with available literature. Results indicate that the scope of conducted reforms is very broad. Yet, reforms related to hospital sector governance and changes in purchasing and payment systems are much more frequent than reforms concerning relations with other providers. Most governance reforms aimed at transforming hospital infrastructure, improving financial management and/or improving quality of care, while purchasing and payment reforms focused on limiting hospital activities and/or on incentivising a shift to ambulatory/day care. Three common challenges included the lack of a comprehensive approach; unclear outcomes; and political influence. Given similar reform areas across countries, there is considerable potential for shared learning.

• MeSH
• nemocnice * MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Bulharsko MeSH
• Česká republika MeSH
• Chorvatsko MeSH
• Estonsko MeSH
• Litva MeSH
• Lotyšsko MeSH
• Maďarsko MeSH
• Polsko MeSH
• Rumunsko MeSH
• Slovenská republika MeSH
• Slovinsko MeSH
• východní Evropa MeSH

Mediterranean spotted fever (MSF) in Bulgaria shows increasing severity, especially in patients over sixty years. As T lymphocytes are the primary effector cells in MSF and are altered by the ageing process we aimed to specify the changes in their numbers in elderly patients. We performed a clinicoepidemiological study, haematological and biochemical analysis of 132 patients of 60+ and 30 patients between 19 and 57 years with MSF. We investigated the cell immunity of 20 patients of 60+ using immunofluocytometry. The control group consisted of 10 younger patients and 10 healthy individuals of 60+. MSF showed more unfavourable course in the elderly.We found T-lymphocytes depletion in all patients with MSF. Activated T lymphocytes were increased in elderly patients with MSF. We found significant differences between the number of activated T lymphocytes in elderly patients and healthy elderly persons. The observed T-lymphocytes depletion in MSF corresponded to the disease severity. The increase in the activated T lymphocytes in patients over 60 years contributes to an adequate immune response.

• MeSH
• antigeny CD3 * fyziologie   MeSH
• buněčná imunita * MeSH
• CD antigeny fyziologie   metabolismus   MeSH
• dospělí MeSH
• HLA-DR antigeny MeSH
• imunitní systém fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• marseillská horečka * metabolismus   patofyziologie   MeSH
• mladý dospělý MeSH
• rickettsiové infekce diagnóza   MeSH
• statistika jako téma MeSH
• T-lymfocyty * fyziologie   metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH