Year: 2025
Type: article
Abstract: Romania's healthcare system struggles with the EU's highest rates of treatable and preventable mortality and the lowest per capita health expenditure. Critical issues include unsustainable financing, an entrenched physician-centered model lacking institutional accountability, delayed digitalization, and inadequate clinical research capacity, necessitating structural and paradigmatic shifts. The objective of this study was to synthesize multi-stakeholder consensus recommendations for comprehensive reform of the Romanian healthcare system, focusing on financing, service delivery, and human resources. This manuscript details recommendations from a multi-stakeholder consensus conference organized in April 2025 by the Aspen Institute Romania. Participants addressed topics including financing, patient-centered hospital models, clinical research, health innovation, and the European Health Data Space (EHDS). Consensus recommendations include: stabilizing national health insurance funds (broadened contributions, multi-year budgets); shifting hospitals to patient-centered, institutionally accountable models (transparent allocation, digital integration, eradicating informal payments); equitable hospital reimbursement (unified tariffs); accelerated digital transformation (EHDS alignment, national Electronic Health Record); enhanced clinical trial capacity (personnel, infrastructure, regulatory efficiency); and exploring regulated dual practice, contingent on successful prior reforms. Key challenges include transforming hospital culture, promoting digital adoption, and navigating the complexities of politics and finance. These interconnected recommendations form a roadmap for transformative reform, crucial given the untenable status quo. Success requires sustained political will, stakeholder collaboration, investment, and robust governance to create a financially stable, patient-centered, equitable, and innovative system.
Source: Journal of Medicine and Life
Authors: Alina Ioana Forray, Teodor Cristian Blidaru, Dragos Garofil, Larisa Mezinu-Bălan, Romanian National Health Insurance House, Bucharest, Romania, Oana Lazăr, Romanian National Health Insurance House, Bucharest, Romania, Iulia Stoea, Romanian National Health Insurance House, Bucharest, Romania, Cristian Vlădescu, Laurențiu Dașcă, Arensia Exploratory Medicine, Bucharest, Romania, Gratiela Iordache, National Authority of Quality Management in Health, Bucharest, Romania, Radu Iliescu, Raluca Sîmbotin, Merck Sharp & Dohme Romania SRL, Bucharest, Romania, Otilia Anghel, Merck Sharp & Dohme Romania SRL, Bucharest, Romania, Adina-Maria Voda, World Bank Romania, Bucharest, Romania, Decebal Mohîrță, Public Affairs Solutions, Bucharest, Romania, Ecaterina Pitel, Guenadiy Vatachki, National Transplant Agency, Bucharest, Romania, Valentina Deleanu, Roche Romania, Bucharest, Romania, Iuliu Cocuz
Institutions: Iuliu Hațieganu University of Medicine and Pharmacy, Carol Davila University of Medicine and Pharmacy, Titu Maiorescu University, Institutul Național de Management al Serviciilor de Sănătate, Grigore T. Popa University of Medicine and Pharmacy, Transylvania University of Brașov, Roche (Romania), Universitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș
Language: English
Subfield: Finance
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W7127634823