Health care provider payment schemes consist of a complex set of arrangements used to influence provider behavior towards specific health policy objectives. The study aimed at: 1) providing a structured, comparative overview of current payment schemes within the public health system in selected Central and Eastern European (CEE) countries for different health care providers; 2) identifying and comparing major changes in payment schemes since 2010. Methods included: 1) data collection form development; 2) desk research; 3) national experts' consultations; 4) comparative analysis. The results indicate that the nine CEE countries (Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania) show numerous similarities in provider payment method mix and in the general direction of the recent changes conducted in this field. Output-based payment methods prevail across all countries and types of providers. Primary health care (PHC) providers are characterized by the most diverse payment method mix. PHC and hospital inpatient care have experienced the most frequent changes in their payment schemes within the last 13 years. These focused mostly on modifying existing payment methods (e.g. detailing payment categories), and applying additional methods to pay for specific services or performance (e.g. fee-for-service, bonus payments). The objectives of conducted change were often similar, thus, there is high potential for a shared, cross-country learning.

• Klíčová slova
• Central and Eastern Europe, Health care provider, Provider payment method, Provider payment scheme,
• MeSH
• dávkové mechanismy * trendy   MeSH
• lidé MeSH
• primární zdravotní péče ekonomika   MeSH
• zdravotní politika MeSH
• zdravotnický personál * ekonomika   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH
• Geografické názvy
• Chorvatsko MeSH
• Evropa MeSH
• Litva MeSH
• Maďarsko MeSH
• Polsko MeSH
• východní Evropa MeSH

INTRODUCTION: Health and social care systems in Central and Eastern European (CEE) countries have undergone significant changes and are currently dealing with serious problems of system disintegration, coordination and a lack of control over the market environment. DESCRIPTION: The increased health needs related to the ageing society and epidemiological patterns in these countries also require funding needs to increase, rationing to be reformed, sectors to be integrated (the managed care approach), and an analytical information base to be developed if supervision of new technological approaches is to improve. The period of system transitions in CEE countries entailed significant changes in their health systems, including health care financing. DISCUSSION: Large deficits in the public financing of health systems were just one of the challenges arising from the economic downturn of the 1990s, which was coupled with inflation, increasing unemployment, low salaries, a large informal sector and tax evasion in a number of CEE countries. During the communist period, there was universal access to a wide range of health services, proving it difficult to retain this coverage. As a result, many states sought to ration publicly funded health services - for example, through patient cost-sharing or decreasing the scope of basic benefits. Yet, not all of these reform plans were implemented, and in fact, some were rolled back or not implemented at all due to a lack of social or political consensus. CONCLUSION: CEE health systems had come to practice implicit rationing in the form of under-the-table payments from patients, quasi-formal payments to providers to compensate for lack of funding, and long waiting lists forcing patients to the private sector. All these difficulties pose a challenge to the implementation of integrated care.

• Klíčová slova
• Central and Eastern Europe, health care, implementation, integrated care, social care,
• Publikační typ
• časopisecké články MeSH