Structural Transitions in the Health Care Systems in Times of Uncertainty

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Background

Health systems may be perceived as a specific institutional configuration of bodies involved in the implementation of tasks related to the maintenance and improvement of population’s health. When the state is engaged in provision of such a function, they are under constant pressure which is generated by the growing expectations of the system’s beneficiaries regarding the public guarantees on access to services, quality of health service and safety of usage. On the other hand, the pressure arises also from financial constraints, as well as expectations expressed by health specialists and other stakeholders, like those involved in the service provision, development of medical and therapeutic technologies, or implementation of specific solutions in the field system organization and management.

Currently, we are facing a specific increase in pressure within the internal and external environment of health systems, resulting from the phenomena observed in the modern world. They are occurring within the demographic structure of populations (commonly observed aging, a dynamic population growth in some parts of the world, mass migrations driven by political and economic factors), in epidemiology (massive problems related to chronic diseases in developed countries, still unresolved, or newly appearing infectious risks), but also in the area of economic and political life (real or frozen military conflicts, destabilization of the dominant forms of political organization in the Western world, the emergence of new players on the global political scene, the changing paradigm in the organization of economic systems and the role of the state). This pressure forces health systems to adapt to the new conditions with new organizational and financial measures. They are to be applied both at the macro and micro levels. First relates to the general organizational structure of the health system, cash flows, financing solutions, staff shortages compensation, etc. The micro perspective appears on the level of the functioning of individual entities: services providers, or those involved in pursuing the health objective in other ways.

The principal objective of the presented Research Topic is to review and assess experiences in transitions of the health systems, applied in response to the needs generated by accompanying circumstances. We assume also to start a discussion on how to reform them, on the horizon determined by the global phenomena we are observing. In other words, we wish it to be a place to generate ideas, that can be operationalized in the face of challenges resulting from these phenomena. Finally, the Topic will also be an attempt to forecast the directions, in which the present and future phenomena will push the evolution of health systems, both in developed, and in developing countries. The proposed thematic scope is wide enough to leave authors a range of possibilities for the selection of specific problems of health system organization and financing. We encourage authors representing countries with a stable organizational structure, and good financial base, as well as researchers focusing on the parts of the world which are particularly affected by the high dynamics of changes in the social, political and economic environment, to participate in the project.

Currently, we are facing a specific increase in pressure within the internal and external environment of health systems, resulting from the phenomena observed in the modern world. They are occurring within the demographic structure of populations (aging in developed countries, a dynamic population growth in other parts of the world, mass migrations driven by political and economic factors), in epidemiology (massive problems of chronic diseases related in developed countries, still unresolved, or newly appearing infectious risks), but also in the area of economic and political life (real and frozen military conflicts, destabilization of the dominant forms of political organization in the Western world, the emergence of new players on the global political scene, the changing paradigm in the organization of economic systems and the role of the state). This pressure forces health systems to adapt to the new conditions with new organizational and financial measures – both at the macro level, related to the general organizational structure of the health system, cash flows, financing solutions, staff shortages compensation, etc., as well as in the micro perspective, relating to the functioning of individual entities: both services providers, or those involved in pursuing the health objective in other ways.

The principal objective of the presented research topic is to review and assess experiences in transforming the systems in response to the challenges generated by accompanying circumstances, but also to start a discussion on the challenges in reforming them on the horizon determined by the global phenomena we are observing, and to generate ideas that can be operationalized in the face of challenges resulting from these phenomena. It will also be an attempt to forecast the directions, in which the present and future phenomena will push the evolution of health systems, both in developed and in developing countries. The proposed thematic scope is wide enough to leave authors a range of possibilities for the selection of specific problems of health system organisation and financing, they wish to focus. We encourage authors representing countries with a stable organisational structure, and good financial base, as well as researchers focusing on the parts of the world, which are particularly affected by the high dynamics of changes in the social, political and economic environment, to participate in the project.

Keywords: Health Systems, Health Reforms, Health System Transition, Health Care Financing, Health Care Management

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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