Overview

Key points

• Georgia has been expanding the package of publicly funded benefits and increasing public spending on health since 2013 in an effort to provide universal health coverage (UHC), although public spending on health is still low in international terms (3.1% of GDP in 2022).
  
• The share of health spending paid for out-of-pocket fell dramatically, from over 80% in 2011 to some 30% in 2022, but coverage policy is complex and there are substantial co-payments.
  
• The high cost of outpatient medicines has been the main barrier to access for those on low-incomes. This was a target for policy action and the cost of over 7000 medicines has been capped.
  
• Recent reforms have set co-payment limits or thresholds for inpatient care for specific groups, improving financial protection and offering clarity on what patients should pay.
  
• Most health care providers are private-for-profit, accounting for around 80% of all hospital beds and most urban primary care provision. The private sector tends to resist central government planning and regulation.
  
• Rural areas are underserved and rely on state-funded primary care by solo practitioners.
  
• There are high rates of doctors per capita, who are concentrated in the capital Tbilisi, with shortages in rural and mountainous areas. In contrast, the country has an acute shortage of nurses, creating increasing barriers to access.
  
• Excess mortality due to COVID-19 far exceeded the regional average.
  
• Access to care for noncommunicable diseases (NCDs) has declined, despite them accounting for most of the country’s morbidity and mortality. NCDs, particularly cancer, are now a focus for policy efforts.
  
• Male smoking prevalence (estimated at 54.6% in 2023) is the highest in Europe. Tobacco control is a public health priority and indoor smoking and tobacco advertising bans have been robust.