Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia.

Tytuł:: Addressing the epidemiologic transition in the former Soviet Union: strategies for health system and public health reform in Russia.
Autorzy:: Tulchinsky TH; School of Public Health Hadassah-Hebrew University, Jerusalem, Israel.
Varavikova EA
Źródło:: American journal of public health [Am J Public Health] 1996 Mar; Vol. 86 (3), pp. 313-20.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]
MeSH Terms:: Health Care Reform*
Health Services Needs and Demand*
Public Health Administration*
Morbidity/*trends
Health Priorities ; Health Status Indicators ; Humans ; Longevity ; Mortality/trends ; Russia/epidemiology
Liczba referencji:: 46
References:: J Health Adm Educ. 1994 Fall;12(4):485-517. (PMID: 10137980)
World Health Stat Q. 1992;45(1):68-74. (PMID: 1413859)
JAMA. 1995 May 24-31;273(20):1569-73. (PMID: 7745761)
World Health Stat Q. 1984;37(4):364-74. (PMID: 6441355)
Am J Public Health. 1990 Feb;80(2):193-7. (PMID: 2297064)
Ann Med. 1990;22(4):211-2. (PMID: 2248754)
Soc Sci Med. 1990;31(8):867-77. (PMID: 2259961)
BMJ. 1991 Jan 19;302(6769):170-1. (PMID: 1995141)
Int J Health Serv. 1991;21(3):493-504. (PMID: 1917209)
Health Aff (Millwood). 1991 Fall;10(3):202-15. (PMID: 1748378)
Health Aff (Millwood). 1991 Fall;10(3):22-38. (PMID: 1748380)
Health Aff (Millwood). 1991 Fall;10(3):71-86. (PMID: 1748393)
Stud Fam Plann. 1991 Nov-Dec;22(6):368-77. (PMID: 1792676)
Health Policy. 1991 Sep;19(1):45-54. (PMID: 10117391)
World Health Stat Q. 1992;45(1):15-28. (PMID: 1413854)
World Health Stat Q. 1992;45(1):29-49. (PMID: 1413855)
Contributed Indexing:: Indexing Agency: IND Local ID #: RH63205. Indexing Agency: POP Local ID #: 00254258.
Keywords: Demographic Factors; Developed Countries; Diseases*; Eastern Europe; Economic Factors; Epidemics*; Europe; Financial Activities; Financing, Government*; Health*; Infant Mortality*; Length Of Life; Life Expectancy*; Maternal Mortality*; Mortality; Nutrition*; Organization And Administration*; Population; Population Dynamics; Public Health*; Russia
Note: TJ: AMERICAN JOURNAL OF PUBLIC HEALTH
Entry Date(s):: Date Created: 19960301 Date Completed: 19960513 Latest Revision: 20190514
Update Code:: 20240104
PubMed Central ID:: PMC1380508
DOI:: 10.2105/ajph.86.3.313
PMID:: 8604754
: Czasopismo naukowe

Pełny tekst

Objectives: This paper reviews Russia's health crisis, financing, and organization and public health reform needs.
Methods: The structure, policy, supply of services, and health status indicators of Russia's health system are examined.
Results: Longevity is declining; mortality rates from cardiovascular diseases and trauma are high and rising; maternal and infant mortality are high. Vaccine-preventable diseases have reappeared in epidemic form. Nutrition status is problematic.
Conclusions: The crisis relates to Russia's economic transition, but it also goes deep into the former Soviet health system. The epidemiologic transition from a predominance of infectious to noninfectious diseases was addressed by increasing the quantity of services. The health system lacked mechanisms for epidemiologic or economic analysis and accountability to the public. Policy and funding favored hospitals over ambulatory care and individual routine checkups over community-oriented preventive approaches. Reform since 1991 has centered on national health insurance and decentralized management of services. A national health strategy to address fundamental public health problems is recommended.

Comment in: Am J Public Health. 1996 Mar;86(3):321-3. (PMID: 8604755)

Informacja