Remediation strategies and systemic improvements in health care after COVID-19: an analysis of international practices in hospital financing

Abstract

During the coronavirus pandemic, health care systems worldwide encountered serious challenges. Many patients were hospitalized, and hospital sectors in numerous countries struggled to handle the crisis. The pandemic caused disruptions in health care delivery and heavily impacted hospital financing. The financial sustainability of hospitals differed among countries, depending on reliance on outpatient and elective services and other features. These gaps drove health organizations to develop new crisis management plans. This review analyzed changes in hospital financing during the pandemic in Poland, Bulgaria, the Czech Republic, Slovakia, Estonia, Latvia, Lithuania, and Georgia. We selected typical post-socialist nations in Central Europe that share similar geopolitical contexts and membership in the European Union, transitioning from centrally planned to market economies with distinct health financing models, as well as Georgia, which aims to become a member of the European Union. The aim of the present study is a comprehensive analysis of international practices of hospital sector financing under the conditions of the COVID-19 pandemic, based on a comparative analysis of crisis response mechanisms in eight countries, with an emphasis on identifying effective remediation strategies and systemic healthcare improvements in the context of financial sustainability, digitalization, and integration into the public health system. Comparing these countries reveals how they adapted to pandemic pressures, employed financial regulations, and addressed challenges, offering insights for similar health systems worldwide. The analysis indicates that the strength and structure of a country’s health financing, especially having an established diagnosis-related group system and comprehensive public health insurance, were crucial for managing the pandemic. Countries with robust systems, such as the Czech Republic, Poland, and Estonia, had better capacity to mobilize resources, adjust funding mechanisms, and support hospitals and staff. In contrast, countries with less well-funded structures, including Bulgaria, Latvia, and Georgia, experienced greater obstacles in their pandemic responses. Remediation of the public health sector within socio-ecological and socio-economic frameworks is essential. It covers a wide spectrum of pressing issues, proposing integrated solutions that safeguard health and improve social and environmental living conditions.

Keywords

• covid-19 pandemic
• health financing system
• financial sustainability
• public health sector
• remediation
• health development strategy