George Gotsadze, Gegi Mataradze, Akaki Zoidze – Hospital Sector Reform and Its Implications on HRD in Georgia
Georgia has excess hospital sector capacity inherited from the old Soviet era. Recent economic problems and decreased public health care expenditures down to 1 USD per capita forced the Georgian Government to embark on ambitious health sector reform since 1995. Reforming the hospital sector was an intrinsic part of the process.
This paper describes major directions of the reform thought by the MoH of Georgia to rationalize the hospital sector. It reviews the reform directions in the environmental context, and attempts to provide some quantitative and qualitative indicators to characterize the reform process and its impact. The discussion addresses the issues of granting autonomy to hospitals, exposure of hospitals to the market, social functions of the hospitals, and improved accountability of hospital facilities. The implications of the reform on HRD are analyzed. The final section of the paper summarizes the lessons learned from the Georgian experience.