Overview

Post-Soviet countries inherited health systems in which hospitals dominated the provision of care. All countries embarked upon plans to improve management, quality and access to specialised and inpatient services, encountering various noteworthy successes but also challenges: attempts to reduce excess hospital capacity did not necessary reflect actual need; lengths of stay tend to be longer than necessary; and hospitals have limited autonomy in managerial decision-making. Obstacles to improving quality often remain, including lack of appropriate hospital equipment or evidence-based medical practice. The financial burden on patients due to growing out-of-pocket payments also poses another barrier to accessing hospital care.