title: The costs of the economic crisis in the health sector.
abstract: BACKGROUND
  The Romanian health care system is facing a period of deep transformations, having in the last years some clear achievements, but also some acknowledged problems. Once the world's economic crisis appeared and manifested its first effects in Romanian economy, there will be some consequences in the health sector too. Regarding the Romanian social health insurance scheme, it's possible to assist to greater financial constraints in 2009 due to reduced contributions and a weaker economy. There are two possible solutions to face this challenge: diminishing the basic health services covered by the social health insurance system (difficult to be accepted by politicians and population) and better use of available resources based on an improvement of allowance and technical efficiency.
  
  
  METHODS
  The authors have made a critical analysis of the Romanian health care system facing the forecasted effects of the economic crisis and have proposed some interventions and solutions to reduce the effects at the level of the patient. In order to increase allowance efficiency clear measures are necessary to be taken at central and local level: improvement of financing mechanisms, alignment of the incentives used by the payment mechanisms for different type of providers, development of guides and protocols based on available resources, etc. For increased technical efficiency there is a need for adequate incentives within the financing and organization mechanisms in order to make the public providers more active in obtaining greater outputs from the available resources. The economic constraints will lead to the growth of the quality of medical services. This is the reason why the health system needs the development of the accreditation systems for providers. The audit of medical activities and reporting represents a mechanism which needs to be developed. Regarding the new health technologies' use new institutions and mechanisms need to be implemented. They will allow making certain decisions on health technologies' use based on cost-effectiveness criteria. The efficient use of the available resources cannot be done without the proper incentives system for professionals who provide health care services. It means that we should establish a better relationship between the professional individual performance and the official revenues.
  
  
  RESULTS
  It's clear that the actual economic crisis will induce effects in the health care sector. It is up to the Government and the physicians, professional bodies and patient's associations to reach a consensus regarding the introduction and the development of some appropriate rules and mechanisms, which will have less effects of the crisis at the patient's level.
authors.affiliation: Medical University Carol Davila Bucharest, Romania. pcradu@snspms.ro
authors.forename: Paul
authors.initials: P
authors.lastname: Radu
authors.forename: Victor
authors.initials: V
authors.lastname: Purcărea
authors.forename: Florian
authors.initials: F
authors.lastname: Popa
mesh_terms: D057172:Economic Recession; D017048:Health Care Costs; D006291:Health Policy / Q000191:economics; D009313:National Health Programs / Q000191:economics; D012383:Romania