Health Systems Improvement Across the Globe: Success Stories from 60 Countries
The world of healthcare is very challenging. Resource-constrained services, creeping bureaucratic requirements, new patient populations with greater needs than ever before, demand in excess of supply, clinician overload, major
and minor breaches of patient safety, politicized workplaces, and ideology masquerading as systems planning: everywhere you look, the barriers to the provision of high-quality care are considerable, and often daunting. In the midst of all these problems, where can we turn for help?
One answer is to change the focus and shift from the negatives to the positives. The very countries in which these types of problems reside always contain examples which have risen above the adversity, and provide solutions to problems. These are success stories that overcome difficulties, surmount obstacles, and deliver an accomplishment worthy of study in its own right.
Professor Jeffrey Braithwaite, as health reform series editor, has led a team of internationally renowned scholars to deliver a compendium of work with precisely this focus. Regional experts Professors Russell Mannion (Europe),
Yukihiro Matsuyama (South-East Asia), Paul Shekelle (the Americas), Stuart Whittaker (Africa), Samir Al-Adawi (Eastern Mediterranean), and Jeffrey Braithwaite (the Western Pacific) have made a concerted effort to harness
the energies, expertise, and analytic ability of 161 authors who have combined to articulate positive messages about healthcare improvement in 60 countries. Rich and poor, northern and southern hemisphere, publicly or
privately funded, technologically sophisticated or focused on the basics: the range of health systems examples, and their differing characteristics, is truly impressive.
As you will see, each team of authors presents a single case example, which narrates a story of accomplishment in their home health system. The sheer diversity of case examples is testament to the range of things that can go right in healthcare. They provide plenty of lessons for those who want to improve care in their own system. Collectively, they act as a set of blueprints for what success looks like across many settings, sectors, and initiatives. That every country enrolled in the project, no matter how politically, financially,
or logistically challenged, could adduce a shining example of success, is a reminder of what can be done by inspiring people who are determined to provide better services to their patient populations.
In addition to being inspiring, this volume, the second in the Taylor & Francis health reform series, is instructive and practically relevant. It is jampacked with the expertise of many far-thinking and generous people across the world who take the task of improving the system they work in or on, very seriously indeed.
For those of us whose appetite for reform and improvement can occasionally flag, or in cases when we become reform weary, this book is just the tonic needed. In a word, it’ s energizing. As the most extensive anthology of health
system success stories ever assembled, we commend this book to you.
During the first 10 years of post-Soviet development, the healthcare sys tem was severely underfunded, and it wasn’ t until 2006 that total funding from all sources approached even the relatively low levels of 1991. No actual healthcare reform was implemented, however, other than the introduction of compulsory medical insurance (CMI). Even Soviet medical provisions for the presidential administration, with their exclusive healthcare facilities and resorts, were retained. However, there were important developments relat ing to aspects of healthcare regulation, the system of incentives, and medical guidelines. The object of this chapter is to present the major developments in the current system of quality management in the Russian healthcare system, and to consider the lessons learned.