格鲁吉亚地方政府参与医院护理改革进程

Ana Tegetashvili, Otar Gerzmava
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引用次数: 0

摘要

文章从科学的角度论述了权力分配问题,并探讨了地方当局在格鲁吉亚医院护理改革领域,特别是在权力下放的条件下可能采取的解决方案。解决这一科学问题的意义在于许多社区,尤其是经济不景气的格鲁吉亚地区面临的财政挑战。在改革之前,医院设施网络依赖于上级预算的补贴。研究方法包括案头研究、对文学、研究和分析资料的二次分析以及监管方法。研究时间跨度为 1991 年至 2022 年,重点关注地方自治政府的权力,包括其固有权力和授权权力,因为近 60% 的医疗服务是在地区社区一级提供的。文章介绍了有关医院医疗管理新模式中财政权力分配的实证分析结果。文章表明,从根本上讲,新模式仍由预算供资,与改革前的结构保持一致。研究从经验和理论上支持了改革总体方向选择恰当的论断,国际专家对此也给予了积极评价。研究结果对代表地方社区利益的地方当局和参与实施这些改革的地方行政当局都很有价值。此外,本研究还与格鲁吉亚对欧洲一体化变革之路的承诺相一致。这一进程在格鲁吉亚的发展非常缓慢。这就失去了提高地方社区生活水平的机会。
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Participation of Georgian Local Authorities in the Process of Hospital Care Reforms
The article addresses power distribution issues within the context of scientific discourse and explores potential solutions to be implemented by local authorities in the realm of Hospital Care reforms in Georgia, particularly in the conditions of authority decentralization. The significance of addressing this scientific issue stems from the financial challenges faced by many communities, especially in economically depressed Georgian regions. Prior to the reform, the network of hospital facilities relied on subsidies from higher-level budgets. The methodological approach involves the use of desk research, secondary analysis of literary, research, and analytical sources, along with regulatory methods. The research spans from 1991 to 2022, focusing on the power of local self-governments, both their inherent powers and those delegated to them, given that almost 60% of medical services are provided at the territorial community level. The article presents empirical analysis results regarding the distribution of financial power in the new model of Hospital care management. It demonstrates that, fundamentally, the new model remains budget-funded, consistent with the pre-reform structure. The research empirically and theoretically supports the assertion that the overall direction of reforms has been appropriately chosen, a sentiment echoed by positive assessments from international experts. The findings of the research can be valuable for local authorities representing the interests of territorial communities and for local executive authorities involved in the implementation of these reforms. Additionally, the research aligns with Georgia's commitment to the path towards European integration changes. This process is developing very slowly in Georgia. This is a loss of opportunity to raise the standard of living of local communities.
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